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Leaf A, Rothschild JA, Sharpe TM, Sims ST, Macias CJ, Futch GG, Roberts MD, Stout JR, Ormsbee MJ, Aragon AA, Campbell BI, Arent SM, D’Agostino DP, Barrack MT, Kerksick CM, Kreider RB, Kalman DS, Antonio J. International society of sports nutrition position stand: ketogenic diets. J Int Soc Sports Nutr 2024; 21:2368167. [PMID: 38934469 PMCID: PMC11212571 DOI: 10.1080/15502783.2024.2368167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
POSITION STATEMENT The International Society of Sports Nutrition (ISSN) provides an objective and critical review of the use of a ketogenic diet in healthy exercising adults, with a focus on exercise performance and body composition. However, this review does not address the use of exogenous ketone supplements. The following points summarize the position of the ISSN. 1. A ketogenic diet induces a state of nutritional ketosis, which is generally defined as serum ketone levels above 0.5 mM. While many factors can impact what amount of daily carbohydrate intake will result in these levels, a broad guideline is a daily dietary carbohydrate intake of less than 50 grams per day. 2. Nutritional ketosis achieved through carbohydrate restriction and a high dietary fat intake is not intrinsically harmful and should not be confused with ketoacidosis, a life-threatening condition most commonly seen in clinical populations and metabolic dysregulation. 3. A ketogenic diet has largely neutral or detrimental effects on athletic performance compared to a diet higher in carbohydrates and lower in fat, despite achieving significantly elevated levels of fat oxidation during exercise (~1.5 g/min). 4. The endurance effects of a ketogenic diet may be influenced by both training status and duration of the dietary intervention, but further research is necessary to elucidate these possibilities. All studies involving elite athletes showed a performance decrement from a ketogenic diet, all lasting six weeks or less. Of the two studies lasting more than six weeks, only one reported a statistically significant benefit of a ketogenic diet. 5. A ketogenic diet tends to have similar effects on maximal strength or strength gains from a resistance training program compared to a diet higher in carbohydrates. However, a minority of studies show superior effects of non-ketogenic comparators. 6. When compared to a diet higher in carbohydrates and lower in fat, a ketogenic diet may cause greater losses in body weight, fat mass, and fat-free mass, but may also heighten losses of lean tissue. However, this is likely due to differences in calorie and protein intake, as well as shifts in fluid balance. 7. There is insufficient evidence to determine if a ketogenic diet affects males and females differently. However, there is a strong mechanistic basis for sex differences to exist in response to a ketogenic diet.
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Affiliation(s)
- Alex Leaf
- Alex Leaf LLC, Scientific Affairs, Scottsdale, AZ, USA
| | - Jeffrey A. Rothschild
- Auckland University of Technology, Sports Performance Research Institute New Zealand, Auckland, New Zealand
- High Performance Sport New Zealand, Performance Nutrition, Auckland, New Zealand
| | - Tim M. Sharpe
- University of Western States, Human Nutrition and Functional Medicine, Portland, OR, USA
| | - Stacy T. Sims
- Auckland University of Technology, Sports Performance Research Institute New Zealand, Auckland, New Zealand
- Stanford University, Stanford Lifestyle Medicine, Palo Alto, CA, USA
| | - Chad J. Macias
- University of Western States, Human Nutrition and Functional Medicine, Portland, OR, USA
| | - Geoff G. Futch
- Springfield College, Department of Exercise Science and Athletic Training, Springfield, MA, USA
- FitPro Analytics, Scientific Affairs, Springfield, MA, USA
| | | | - Jeffrey R. Stout
- University of Central Florida, School of Kinesiology and Rehabilitation Sciences, Orlando, FL, USA
| | - Michael J. Ormsbee
- Florida State University, Institute of Sports Sciences & Medicine, Tallahassee, FL, USA
- University of KwaZulu Natal, Discipline of Biokinetics, Exercise and Leisure Sciences, Durban, South Africa
| | | | - Bill I. Campbell
- University of South Florida, Performance and Physique Enhancement Laboratory, Exercise Science Program, Tampa, FL, USA
| | - Shawn M. Arent
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, Columbia, SC, USA
| | - Dominic P. D’Agostino
- Institute for Human and Machine Cognition, Human Healthspan, Resilience, and Performance, Pensacola, FL, USA
- University of South Florida, Department of Molecular Pharmacology and Physiology, Tampa, FL, USA
| | - Michelle T. Barrack
- California State University, Department of Family and Consumer Sciences, Long Beach, CA, USA
| | - Chad M. Kerksick
- Lindenwood University, Exercise and Performance Nutrition Laboratory, College of Science, Technology, and Health, St. Charles, MO, USA
| | - Richard B. Kreider
- Texas A&M University, Exercise and Sport Nutrition Lab, Department of Kinesiology and Sports Management, College Station, TX, USA
| | - Douglas S. Kalman
- Nova Southeastern University, Department of Nutrition. Dr. Kiran C. Patel College of Osteopathic Medicine. Davie, FL, USA
| | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, FL, USA
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Tien DS, Hockey M, So D, Stanford J, Clarke ED, Collins CE, Staudacher HM. Recommendations for Designing, Conducting, and Reporting Feeding Trials in Nutrition Research. Adv Nutr 2024; 15:100283. [PMID: 39134209 PMCID: PMC11480951 DOI: 10.1016/j.advnut.2024.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/05/2024] [Accepted: 08/07/2024] [Indexed: 09/01/2024] Open
Abstract
Double-blind, placebo-controlled, randomized controlled trials are the gold standard for clinical trials in nutrition science. For trials of whole diets, dietary counseling is advantageous as they offer clinical translatability although can vary in the fidelity of the intended intervention from participant to participant and across studies. Feeding trials, in which most or all food is provided, offer high precision and can provide proof-of-concept evidence that a dietary intervention is efficacious and can also better evaluate the effect of known quantities of foods and nutrients on physiology. However, they come with additional methodological complexities. Feeding trials also call for a variety of unique methodological considerations, not least of which relate to the design and delivery of diets to participants. This review aims to provide a comprehensive summary of recommendations for design and conduct of feeding trials, encompassing domiciled and nondomiciled feeding trials. Several pertinent aspects of trial design and methodology are discussed, including defining the study population to maximize retention, safety, and generalizability of findings, recommendations for design of control interventions and optimizing blinding, and specific considerations for clinical populations. A detailed stepwise process for menu design, development, validation, and delivery are also presented. These recommendations aim to facilitate methodologic consistency and execution of high-quality feeding trials, ultimately facilitating improved understanding of the role of diet in treating disease and the underpinning mechanisms.
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Affiliation(s)
- Delyse Sy Tien
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Victoria, Australia
| | - Meghan Hockey
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Victoria, Australia
| | - Daniel So
- Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia
| | - Jordan Stanford
- School of Health Sciences, College of Health Medicine and Wellbeing, the University of Newcastle, New South Wales, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Erin D Clarke
- School of Health Sciences, College of Health Medicine and Wellbeing, the University of Newcastle, New South Wales, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health Medicine and Wellbeing, the University of Newcastle, New South Wales, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Heidi M Staudacher
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Victoria, Australia.
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Sciarrillo CM, Guo J, Hengist A, Darcey VL, Hall KD. Diet order significantly affects energy balance for diets varying in macronutrients but not ultraprocessing in crossover studies without a washout period. Am J Clin Nutr 2024; 120:953-963. [PMID: 39163976 PMCID: PMC11473439 DOI: 10.1016/j.ajcnut.2024.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 08/02/2024] [Accepted: 08/13/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Crossover studies can induce order effects, especially when they lack a washout period. OBJECTIVES We performed secondary analyses comparing groups of subjects randomly assigned to different diet orders in 2 inpatient crossover studies originally designed to compare within-subject differences in ad libitum energy intake. One study compared minimally processed low-carbohydrate (LC) compared with low-fat (LF) diets, and the other matched macronutrients and compared minimally processed food (MPF) with ultraprocessed food (UPF) diets. METHODS Diet order group comparisons of changes in body weight and body composition, and differences in energy expenditure and food intake were assessed over 4 wk in 20 adults randomly assigned to either the LC followed immediately by the LF diet (LC → LF) or the opposite order (LF → LC), and 20 adults randomly assigned to either the MPF followed by the UPF (MPF → UPF) diets or the opposite order (UPF → MPF). RESULTS Subjects randomly assigned to LC → LF lost 2.9 ± 1.1 kg more body weight (P <0.001) and 1.5 ± 0.6 kg more body fat (P = 0.03) than the LF → LC group, likely because the LC → LF group consumed 921 ± 304 kcal/d less than the LF → LC group (P = 0.003). These energy intake differences were driven by the last 2 wk (-1610 ± 312 kcal/d; P < 0.0001), perhaps because of carryover effects of gut adaptations during the first 2 wk arising from large differences in the mass of food (1296 ± 215 g/d; P <0.00001) and fiber consumed (58 ± 6 g/d; P <0.00001). There were no significant diet order effects on energy intake, body weight, or body composition changes between UPF → MPF and MPF → UPF groups. CONCLUSIONS Diet order significantly affected energy intake, body weight, and body fat in a 4-wk crossover inpatient diet study varying in macronutrients, but not in a similarly structured study varying in ultraprocessed foods. This trial was registered at clinicaltrials.gov as NCT03407053 and NCT03878108.
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Affiliation(s)
- Christina M Sciarrillo
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United States
| | - Juen Guo
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United States
| | - Aaron Hengist
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United States
| | - Valerie L Darcey
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United States
| | - Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, United States.
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Hengist A, Sciarrillo CM, Guo J, Walter M, Hall KD. Gut-derived appetite hormones do not explain energy intake differences in humans following low-carbohydrate versus low-fat diets. Obesity (Silver Spring) 2024; 32:1689-1698. [PMID: 39113385 PMCID: PMC11357890 DOI: 10.1002/oby.24104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/16/2024] [Accepted: 05/29/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVE The objective of this study was to explore how dietary macronutrient composition influences postprandial appetite hormone responses and subsequent energy intake. METHODS A total of 20 adults (mean [SEM], age 30 [1] years, BMI 27.8 [1.3] kg/m2, n = 8 with normal weight, n = 6 with overweight, n = 6 with obesity) consumed a low-fat (LF) diet (10% fat, 75% carbohydrate) and a low-carbohydrate (LC) diet (10% carbohydrate, 75% fat) for 2 weeks each in an inpatient randomized crossover design. At the end of each diet, participants consumed isocaloric macronutrient-representative breakfast test meals, and 6-h postprandial responses were measured. Ad libitum energy intake was measured for the rest of the day. RESULTS The LC meal resulted in greater mean postprandial plasma active glucagon-like peptide-1 (GLP-1; LC: 6.44 [0.78] pg/mL, LF: 2.46 [0.26] pg/mL; p < 0.0001), total glucose-dependent insulinotropic polypeptide (GIP; LC: 578 [60] pg/mL, LF: 319 [37] pg/mL; p = 0.0004), and peptide YY (PYY; LC: 65.6 [5.6] pg/mL, LF: 50.7 [3.8] pg/mL; p = 0.02), whereas total ghrelin (LC: 184 [25] pg/mL, LF: 261 [47] pg/mL; p = 0.0009), active ghrelin (LC: 91 [9] pg/mL, LF: 232 [28] pg/mL; p < 0.0001), and leptin (LC: 26.9 [6.5] ng/mL, LF: 35.2 [7.5] ng/mL; p = 0.01) were lower compared with LF. Participants ate more during LC at lunch (244 [85] kcal; p = 0.01) and dinner (193 [86] kcal; p = 0.04), increasing total subsequent energy intake for the day compared with LF (551 [103] kcal; p < 0.0001). CONCLUSIONS In the short term, endogenous gut-derived appetite hormones do not necessarily determine ad libitum energy intake.
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Affiliation(s)
- Aaron Hengist
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
| | - Christina M. Sciarrillo
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
| | - Juen Guo
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
| | - Mary Walter
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
| | - Kevin D. Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
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Al‐Ibraheem AMT, Hameed AAZ, Marsool MDM, Jain H, Prajjwal P, Khazmi I, Nazzal RS, AL‐Najati HMH, Al‐Zuhairi BHYK, Razzaq M, Abd ZB, Marsool ADM, wahedaldin AI, Amir O. Exercise-Induced cytokines, diet, and inflammation and their role in adipose tissue metabolism. Health Sci Rep 2024; 7:e70034. [PMID: 39221051 PMCID: PMC11365580 DOI: 10.1002/hsr2.70034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 04/23/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024] Open
Abstract
Background Obesity poses a significant global health challenge, necessitating effective prevention and treatment strategies. Exercise and diet are recognized as pivotal interventions in combating obesity. This study reviews the literature concerning the impact of exercise-induced cytokines, dietary factors, and inflammation on adipose tissue metabolism, shedding light on potential pathways for therapeutic intervention. Methodology A comprehensive review of relevant literature was conducted to elucidate the role of exercise-induced cytokines, including interleukin-6 (IL-6), interleukin-15 (IL-15), brain-derived neurotrophic factor (BDNF), irisin, myostatin, fibroblast growth factor 21 (FGF21), follistatin (FST), and angiopoietin-like 4 (ANGPTL4), in adipose tissue metabolism. Various databases were systematically searched using predefined search terms to identify relevant studies. Articles selected for inclusion underwent thorough analysis to extract pertinent data on the mechanisms underlying the influence of these cytokines on adipose tissue metabolism. Results and Discussion Exercise-induced cytokines exert profound effects on adipose tissue metabolism, influencing energy expenditure (EE), thermogenesis, fat loss, and adipogenesis. For instance, IL-6 activates AMP-activated protein kinase (AMPK), promoting fatty acid oxidation and reducing lipogenesis. IL-15 upregulates peroxisome proliferator-activated receptor delta (PPARδ), stimulating fatty acid catabolism and suppressing lipogenesis. BDNF enhances AMPK-dependent fat oxidation, while irisin induces the browning of white adipose tissue (WAT), augmenting thermogenesis. Moreover, myostatin, FGF21, FST, and ANGPTL4 each play distinct roles in modulating adipose tissue metabolism, impacting factors such as fatty acid oxidation, adipogenesis, and lipid uptake. The elucidation of these pathways offers valuable insights into the complex interplay between exercise, cytokines, and adipose tissue metabolism, thereby informing the development of targeted obesity management strategies. Conclusion Understanding the mechanisms by which exercise-induced cytokines regulate adipose tissue metabolism is critical for devising effective obesity prevention and treatment modalities. Harnessing the therapeutic potential of exercise-induced cytokines, in conjunction with dietary interventions, holds promise for mitigating the global burden of obesity. Further research is warranted to delineate the precise mechanisms underlying the interactions between exercise, cytokines, and adipose tissue metabolism.
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Affiliation(s)
| | | | | | - Hritvik Jain
- All India Institute of Medical SciencesJodhpurIndia
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Fernández-Verdejo R, Sanchez-Delgado G, Ravussin E. Energy Expenditure in Humans: Principles, Methods, and Changes Throughout the Life Course. Annu Rev Nutr 2024; 44:51-76. [PMID: 38759093 DOI: 10.1146/annurev-nutr-062122-031443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Humans require energy to sustain their daily activities throughout their lives. This narrative review aims to (a) summarize principles and methods for studying human energy expenditure, (b) discuss the main determinants of energy expenditure, and (c) discuss the changes in energy expenditure throughout the human life course. Total daily energy expenditure is mainly composed of resting energy expenditure, physical activity energy expenditure, and the thermic effect of food. Total daily energy expenditure and its components are estimated using variations of the indirect calorimetry method. The relative contributions of organs and tissues determine the energy expenditure under different physiological conditions. Evidence shows that energy expenditure varies along the human life course, at least in part due to changes in body composition, the mass and specific metabolic rates of organs and tissues, and levels of physical activity. This information is crucial to estimate human energy requirements for maintaining health throughout the life course.
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Affiliation(s)
- Rodrigo Fernández-Verdejo
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA;
| | - Guillermo Sanchez-Delgado
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA;
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
- Department of Medicine, Division of Endocrinology, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Canada
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Sport and Health University Research Institute and "José Mataix Verdú" Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Eric Ravussin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA;
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Carnero EA, Corbin KD, Casu A, Igudesman D, Bilal A, Smith SR, Kosorok MR, Maahs DM, Mayer-Davis EJ, Pratley RE. 24-h energy expenditure in people with type 1 diabetes: impact on equations for clinical estimation of energy expenditure. Eur J Clin Nutr 2024; 78:718-725. [PMID: 38745052 DOI: 10.1038/s41430-024-01446-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND/OBJECTIVES Type 1 diabetes (T1D) is associated with an increase in resting metabolic rate (RMR), but the impact of T1D on other components of 24-h energy expenditure (24-h EE) is not known. Also, there is a lack of equations to estimate 24-h EE in patients with T1D. The aims of this analysis were to compare 24-h EE and its components in young adults with T1D and healthy controls across the spectrum of body mass index (BMI) and derive T1D-specific equations from clinical variables. SUBJECTS/METHODS Thirty-three young adults with T1D diagnosed ≥1 year prior and 33 healthy controls matched for sex, age and BMI were included in this analysis. We measured 24-h EE inside a whole room indirect calorimeter (WRIC) and body composition with dual x-ray absorptiometry. RESULTS Participants with T1D had significantly higher 24-h EE than healthy controls (T1D = 2047 ± 23 kcal/day vs control= 1908 ± 23 kcal/day; P < 0.01). We derived equations to estimate 24-h EE with both body composition (fat free mass + fat mass) and anthropometric (weight + height) models, which provided high coefficients of determination (R2 = 0.912 for both). A clinical model that did not incorporate spontaneous physical activity yielded high coefficients of determination as well (R2 = 0.897 and R2 = 0.880 for body composition and anthropometric models, respectively). CONCLUSION These results confirm that young adults with established T1D have increased 24-h EE relative to controls without T1D. The derived equations from clinically available variables can assist clinicians with energy prescriptions for weight management in patients with T1D.
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Affiliation(s)
- Elvis A Carnero
- AdventHealth Translational Research Institute, 301 E. Princeton St., Orlando, FL, 32804, USA.
| | - Karen D Corbin
- AdventHealth Translational Research Institute, 301 E. Princeton St., Orlando, FL, 32804, USA
| | - Anna Casu
- AdventHealth Translational Research Institute, 301 E. Princeton St., Orlando, FL, 32804, USA
| | - Daria Igudesman
- AdventHealth Translational Research Institute, 301 E. Princeton St., Orlando, FL, 32804, USA
| | - Anika Bilal
- AdventHealth Translational Research Institute, 301 E. Princeton St., Orlando, FL, 32804, USA
| | - Steven R Smith
- AdventHealth Translational Research Institute, 301 E. Princeton St., Orlando, FL, 32804, USA
| | - Michael R Kosorok
- Department of Biostatistics, University of North Carolina at Chapel Hill, 3101 McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA
| | - David M Maahs
- Department of Pediatrics, Division of Endocrinology, Stanford University, School of Medicine. 300 Pasteur Dr., Stanford, CA, 94305, USA
- Stanford Diabetes Research Center, Stanford, CA, 94305, USA
- Department of Epidemiology, Stanford University, School of Medicine, Stanford, CA, 94305, USA
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Medicine, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Richard E Pratley
- AdventHealth Translational Research Institute, 301 E. Princeton St., Orlando, FL, 32804, USA
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Purcell SA, LaMunion SR, Chen KY, Rynders CA, Thomas EA, Melanson EL. The use of accelerometers to improve estimation of the thermic effect of food in whole room calorimetry studies. J Appl Physiol (1985) 2024; 137:1-9. [PMID: 38695352 PMCID: PMC11389891 DOI: 10.1152/japplphysiol.00763.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/11/2024] [Accepted: 04/23/2024] [Indexed: 06/28/2024] Open
Abstract
We tested whether spontaneous physical activity (SPA) from accelerometers could be used in a whole room calorimeter to estimate thermic effect of food (TEF). Eleven healthy participants (n = 7 females; age: 27 ± 4 yr; body mass index: 22.8 ± 2.6 kg/m2) completed two 23-h visits in randomized order: one "fed" with meals provided and one "fasted" with no food. SPA was measured by ActivPAL and Actigraph accelerometers. Criterion TEF was calculated as the difference in total daily energy expenditure (TDEE) between fed and fasted visits and compared with three methods of estimating TEF: 1) SPA-adjusted TEF (adjTEF)-difference in TDEE without SPA between visits, 2) Wakeful TEF-difference in energy expenditure obtained from linear regression and basal metabolic rate during waking hours, 3) 24-h TEF-increase in TDEE above SPA and sleeping metabolic rate. Criterion TEF was 9.4 ± 4.5% of TDEE. AdjTEF (difference in estimated vs. criterion TEF: activPAL: -0.3 ± 3.3%; Actigraph: -1.8 ± 8.0%) and wakeful TEF (activPAL: -0.9 ± 6.1%; Actigraph: -2.8 ± 7.6%) derived from both accelerometers did not differ from criterion TEF (all P > 0.05). ActivPAL-derived 24-h TEF overestimated TEF (6.8 ± 5.4%, P = 0.002), whereas Actigraph-derived 24-h TEF was not significantly different (4.3 ± 9.4%, P = 0.156). TEF estimations using activPAL tended to show better individual-level agreement (i.e., smaller coefficients of variation). Both accelerometers can be used to estimate TEF in a whole room calorimeter; wakeful TEF using activPAL is the most viable option given strong group-level accuracy and reasonable individual agreement.NEW & NOTEWORTHY Two research-grade accelerometers can effectively estimate spontaneous physical activity and improve the estimation of thermic effect of food (TEF) in whole room calorimeters. The activPAL demonstrates strong group-level accuracy and reasonable individual-level agreement in estimating wakeful TEF, whereas a hip-worn Actigraph is an acceptable approach for estimating 24-h TEF. These results highlight the promising potential of accelerometers in advancing energy balance research by improving the assessment of TEF within whole room calorimeters.
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Affiliation(s)
- Sarah A Purcell
- Division of Endocrinology Metabolism and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Biology, Irving K. Barber Faculty of Science, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Samuel R LaMunion
- Diabetes, Endocrinology, and Obesity Branch, Intramural Research Program, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, United States
| | - Kong Y Chen
- Diabetes, Endocrinology, and Obesity Branch, Intramural Research Program, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, United States
| | - Corey A Rynders
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Elizabeth A Thomas
- Division of Endocrinology Metabolism and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado, United States
| | - Edward L Melanson
- Division of Endocrinology Metabolism and Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
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Li X, Yang J, Zhou X, Dai C, Kong M, Xie L, Liu C, Liu Y, Li D, Ma X, Dai Y, Sun Y, Jian Z, Guo X, Lin X, Li Y, Sun L, Liu X, Jin L, Tang H, Zheng Y, Hong S. Ketogenic diet-induced bile acids protect against obesity through reduced calorie absorption. Nat Metab 2024; 6:1397-1414. [PMID: 38937659 DOI: 10.1038/s42255-024-01072-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/24/2024] [Indexed: 06/29/2024]
Abstract
The low-carbohydrate ketogenic diet (KD) has long been practiced for weight loss, but the underlying mechanisms remain elusive. Gut microbiota and metabolites have been suggested to mediate the metabolic changes caused by KD consumption, although the particular gut microbes or metabolites involved are unclear. Here, we show that KD consumption enhances serum levels of taurodeoxycholic acid (TDCA) and tauroursodeoxycholic acid (TUDCA) in mice to decrease body weight and fasting glucose levels. Mechanistically, KD feeding decreases the abundance of a bile salt hydrolase (BSH)-coding gut bacterium, Lactobacillus murinus ASF361. The reduction of L. murinus ASF361 or inhibition of BSH activity increases the circulating levels of TDCA and TUDCA, thereby reducing energy absorption by inhibiting intestinal carbonic anhydrase 1 expression, which leads to weight loss. TDCA and TUDCA treatments have been found to protect against obesity and its complications in multiple mouse models. Additionally, the associations among the abovementioned bile acids, microbial BSH and metabolic traits were consistently observed both in an observational study of healthy human participants (n = 416) and in a low-carbohydrate KD interventional study of participants who were either overweight or with obesity (n = 25). In summary, we uncover a unique host-gut microbiota metabolic interaction mechanism for KD consumption to decrease body weight and fasting glucose levels. Our findings support TDCA and TUDCA as two promising drug candidates for obesity and its complications in addition to a KD.
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Affiliation(s)
- Xiao Li
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Jie Yang
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Xiaofeng Zhou
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Chen Dai
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Mengmeng Kong
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Linshan Xie
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Chenglin Liu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
- Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Precision Cancer Medicine Center, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
| | - Yilian Liu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Dandan Li
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Xiaonan Ma
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Yuxiang Dai
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai, P.R. China
| | - Yan Sun
- Masonic Medical Research Institute, Utica, NY, USA
| | - Zhijie Jian
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Xiaohuan Guo
- Institute for Immunology, Tsinghua University, Beijing, P.R. China
| | - Xu Lin
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, P.R. China
- Key Laboratory of Systems Biology, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Hangzhou, P.R. China
| | - Yixue Li
- Bio-Med Big Data Center, Key Laboratory of Computational Biology, CAS-MPG Partner Institute for Computational Biology, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, P.R. China
- Collaborative Innovation Center for Genetics and Development, Fudan University, Shanghai, P.R. China
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Liang Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, P.R. China
| | - Xin Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Li Jin
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Huiru Tang
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China.
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai, P.R. China.
- Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, P.R. China.
| | - Shangyu Hong
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, P.R. China.
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10
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Burén J, Svensson M, Liv P, Sjödin A. Effects of a Ketogenic Diet on Body Composition in Healthy, Young, Normal-Weight Women: A Randomized Controlled Feeding Trial. Nutrients 2024; 16:2030. [PMID: 38999778 PMCID: PMC11243114 DOI: 10.3390/nu16132030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
This study investigates the effects of a ketogenic low-carbohydrate high-fat (LCHF) diet on body composition in healthy, young, normal-weight women. With the increasing interest in ketogenic diets for their various health benefits, this research aims to understand their impact on body composition, focusing on women who are often underrepresented in such studies. Conducting a randomized controlled feeding trial with a crossover design, this study compares a ketogenic LCHF diet to a Swedish National Food Agency (NFA)-recommended control diet over four weeks. Seventeen healthy, young, normal-weight women adhered strictly to the provided diets, with ketosis confirmed through blood β-hydroxybutyrate concentrations. Dual-energy X-ray absorptiometry (DXA) was utilized for precise body composition measurements. To avoid bias, all statistical analyses were performed blind. The findings reveal that the ketogenic LCHF diet led to a significant reduction in both lean mass (-1.45 kg 95% CI: [-1.90;-1.00]; p < 0.001) and fat mass (-0.66 kg 95% CI: [-1.00;-0.32]; p < 0.001) compared to the control diet, despite similar energy intake and physical activity levels. This study concludes that while the ketogenic LCHF diet is effective for weight loss, it disproportionately reduces lean mass over fat mass, suggesting the need for concurrent strength training to mitigate muscle loss in women following this diet.
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Affiliation(s)
- Jonas Burén
- Department of Food, Nutrition and Culinary Science, Umeå University, 90187 Umeå, Sweden;
- Umeå School of Sport Sciences, Umeå University, 90187 Umeå, Sweden;
| | - Michael Svensson
- Umeå School of Sport Sciences, Umeå University, 90187 Umeå, Sweden;
- Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, 90187 Umeå, Sweden
| | - Per Liv
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, 90187 Umeå, Sweden;
| | - Anna Sjödin
- Department of Food, Nutrition and Culinary Science, Umeå University, 90187 Umeå, Sweden;
- Umeå School of Sport Sciences, Umeå University, 90187 Umeå, Sweden;
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11
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Wu X, Xu Y, Liu Y, Ma A, Zhong F, Gao T, Cai J, Chen Y, Wang Y, Zhou W, Ma Y. Relationships between oral function, dietary intake and nutritional status in older adults aged 75 years and above: a cross-sectional study. BMC Public Health 2024; 24:1465. [PMID: 38822295 PMCID: PMC11143706 DOI: 10.1186/s12889-024-18906-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 05/21/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Malnutrition is related to impaired oral health and function that causes poor dietary intake, declining the general health of older adults. The role of dietary intake in the association between oral function and nutritional status of Chinese older adults (aged 75 and above) was examined in this cross-sectional study. METHODS Through the randomized cluster sampling method, 267 older adults living in rural areas of Qingdao, Shandong (aged 81.4 ± 4.3, 75-94 years) were chosen as the primary research participants. A Mini Nutritional Assessment - Short Form was used to determine nutritional status, and Food Frequency Questionnaire and 24-hour Food Intake Recall were used to assess dietary intake. The oral function was evaluated by analyzing the teeth, oral problems, bite force, tongue pressure, lip sealing pressure, chewing function questionnaire, whole saliva flow rate, 10-Item Eating Assessment Tool, and water swallow test. RESULTS Based on the MNA-SF score, it was divided into a well-nourished group and a malnutrition group, with the malnutrition group comprising 40.6% of participants. The participants in the malnutrition group showed a higher rate of xerostomia, lower bite force, tongue pressure, and lip sealing pressure, and higher Chewing Function Questionnaire and 10-Item Eating Assessment Tool scores. Furthermore, their plant fat, iron, cereals and potatoes, vegetables, fruits, and seafood intake were relatively low. The regression model indicated that exercise frequency, stroke, chewing and swallowing function, intake of vegetables and fruits were risk factors for nutritional status of older adults. CONCLUSION Malnutrition was relatively common among the Chinese older adults aged 75 and above, and it was significantly correlated with exercise frequency, stroke, chewing and swallowing function, and intake of vegetables and fruits. Therefore, nutrition management should be carried out under the understanding and guidance of the oral function and dietary intake of the older adults.
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Affiliation(s)
- Xiaoqing Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Yanqiu Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Yajun Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Aiguo Ma
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Feng Zhong
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Tianlin Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Jing Cai
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Yong Chen
- School of Food Science and Biotechnology, Food Oral Processing Laboratory, Zhejiang Gongshang University, Hangzhou, Zhejiang, China
| | - Yali Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Wenkai Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Yan Ma
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China.
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12
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Hassell Sweatman CZW. Modelling remission from overweight type 2 diabetes reveals how altering advice may counter relapse. Math Biosci 2024; 371:109180. [PMID: 38518862 DOI: 10.1016/j.mbs.2024.109180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/22/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
The development or remission of diet-induced overweight type 2 diabetes involves many biological changes which occur over very different timescales. Remission, defined by HbA1c<6.5%, or fasting plasma glucose concentration G<126 mg/dl, may be achieved rapidly by following weight loss guidelines. However, remission is often short-term, followed by relapse. Mathematical modelling provides a way of investigating a typical situation, in which patients are advised to lose weight and then maintain fat mass, a slow variable. Remission followed by relapse, in a modelling sense, is equivalent to changing from a remission trajectory with steady state G<126 mg/dl, to a relapse trajectory with steady state G≥126 mg/dl. Modelling predicts that a trajectory which maintains weight will be a relapse trajectory, if the fat mass chosen is too high, the threshold being dependent on the lipid to carbohydrate ratio of the diet. Modelling takes into account the effects of hepatic and pancreatic lipid on hepatic insulin sensitivity and β-cell function, respectively. This study leads to the suggestion that type 2 diabetes remission guidelines be given in terms of model parameters, not variables; that is, the patient should adhere to a given nutrition and exercise plan, rather than achieve a certain subset of variable values. The model predicts that calorie restriction, not weight loss, initiates remission from type 2 diabetes; and that advice of the form 'adhere to the diet and exercise plan' rather than 'achieve a certain weight loss' may help counter relapse.
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Affiliation(s)
- Catherine Z W Hassell Sweatman
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, 55 Wellesley Street East, Auckland 1010, New Zealand.
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13
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Livzan MA, Lyalyukova EA, Druk IV, Safronova SS, Khalashte AA, Martirosian KA, Petrosian VY, Galakhov YS. Obesity: current state of the problem, multidisciplinary approach. (based on the consensus of the World Gastroenterological Organization “Obesity 2023” and the European guideline on obesity care in patients with gastrointestinal and liver diseases, 2022). EXPERIMENTAL AND CLINICAL GASTROENTEROLOGY 2024:5-47. [DOI: 10.31146/1682-8658-ecg-218-10-5-47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
Obesity is the largest pandemic in the world, and its prevalence continues to increase. The purpose of the presented publication is to raise awareness of doctors about modern methods of diagnosing obesity and approaches to therapy, using an interdisciplinary team approach similar to that used in other chronic diseases, such as diabetes, heart disease and cancer. The article presents data from the World Gastroenterological Organization (2023) and the European Guidelines for the Treatment of Obesity in patients with diseases of the gastrointestinal tract and liver (2022). According to modern approaches, obesity should be considered as a chronic recurrent progressive disease, the treatment of which requires a comprehensive interdisciplinary approach involving psychologists and psychiatrists, nutritionists/nutritionists, therapists, endoscopists and surgeons, including lifestyle changes, a well-defined diet and exercise regimen, drug therapy, endoscopic or surgical methods of treatment. Conclusions. In order to stop the growing wave of obesity and its many complications and costs, doctors, insurance companies and health authorities should make systematic efforts to raise public awareness of both the adverse health risks associated with obesity and the potential reduction of risks through a comprehensive approach to therapy.
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14
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Dabas J, Shunmukha Priya S, Alawani A, Budhrani P. What could be the reasons for not losing weight even after following a weight loss program? JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:37. [PMID: 38429842 PMCID: PMC10908186 DOI: 10.1186/s41043-024-00516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION Approximately four million people worldwide die annually because of obesity. Weight loss is commonly recommended as a first-line therapy in overweight and obese patients. Although many individuals attempt to lose weight, not everyone achieves optimal success. Few studies point out that weight loss eventually slows down, stagnates or reverses in 85% of the cases. RESEARCH QUESTION What could be the reasons for not losing weight even after following a weight loss program? METHODS A scoping review of the literature was performed using weight loss-related search terms such as 'Obesity,' 'Overweight,' 'Lifestyle,' 'weight loss,' 'Basal Metabolism,' 'physical activity,' 'adherence,' 'energy balance,' 'Sleep' and 'adaptations. The search involved reference tracking and database and web searches (PUBMED, Science Direct, Elsevier, Web of Science and Google Scholar). Original articles and review papers on weight loss involving human participants and adults aged > 18 years were selected. Approximately 231 articles were reviewed, and 185 were included based on the inclusion criteria. DESIGN Scoping review. RESULTS In this review, the factors associated with not losing weight have broadly been divided into five categories. Studies highlighting each subfactor were critically reviewed and discussed. A wide degree of interindividual variability in weight loss is common in studies even after controlling for variables such as adherence, sex, physical activity and baseline weight. In addition to these variables, variations in factors such as previous weight loss attempts, sleep habits, meal timings and medications can play a crucial role in upregulating or downregulating the association between energy deficit and weight loss results. CONCLUSION This review identifies and clarifies the role of several factors that may hinder weight loss after the exploration of existing evidence. Judging the effectiveness of respective lifestyle interventions by simply observing the 'general behavior of the groups' is not always applicable in clinical practice. Each individual must be monitored and advised as per their requirements and challenges.
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Affiliation(s)
- Jyoti Dabas
- Institute of Nutrition and Fitness Sciences, Platinum Square, 4th floor, Office, 403, Opp. WNS, Sakore Nagar, Viman Nagar, Pune, Maharashtra, 411014, India
| | - S Shunmukha Priya
- Institute of Nutrition and Fitness Sciences, Platinum Square, 4th floor, Office, 403, Opp. WNS, Sakore Nagar, Viman Nagar, Pune, Maharashtra, 411014, India.
| | - Akshay Alawani
- Institute of Nutrition and Fitness Sciences, Platinum Square, 4th floor, Office, 403, Opp. WNS, Sakore Nagar, Viman Nagar, Pune, Maharashtra, 411014, India
| | - Praveen Budhrani
- Institute of Nutrition and Fitness Sciences, Platinum Square, 4th floor, Office, 403, Opp. WNS, Sakore Nagar, Viman Nagar, Pune, Maharashtra, 411014, India
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15
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Lamunion SR, Brychta RJ, Saint-Maurice PF, Matthews CE, Chen KY. Does Wrist-Worn Accelerometer Wear Compliance Wane over a Free-Living Assessment Period? An NHANES Analysis. Med Sci Sports Exerc 2024; 56:209-220. [PMID: 37703285 PMCID: PMC10872893 DOI: 10.1249/mss.0000000000003301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
PURPOSE Accelerometers are used to objectively measure physical behaviors in free-living environments, typically for seven consecutive days or more. We examined whether participants experience "wear fatigue," a decline in wear time day over day, during typical assessment period acquired in a nationally representative sample of 6- to 80-yr-olds in the United States. METHODS Participants were instructed to wear an ActiGraph GT3X+ on their nondominant wrist continuously for seven consecutive days. Participants with seven complete days of recorded data, regardless of wear status, were included in the analyses ( N = 13,649). Wear was scored with the sleep, wake, and nonwear algorithm. RESULTS Participants averaged 1248 ± 3.6 min·d -1 (mean ± SE) of wear over the assessment, but wear time linearly decreased from day 1 (1295 ± 3.2 min) to day 7 (1170 ± 5.3 min), resulting in a wear fatigue of -18.1 ± 0.7 min·d -1 ( β ± SE). Wear fatigue did not differ by sex but varied by age-group-highest in adolescents (-26.8 ± 2.4 min·d -1 ) and lowest in older adults (-9.3 ± 0.9 min·d -1 ). Wear was lower in evening (1800-2359 h) and early morning (0000-0559 h) compared with the middle of the day and on weekend days compared with weekdays. We verified similar wear fatigue (-23.5 ± 0.7 min·d -1 ) in a separate sample ( N = 14,631) with hip-worn devices and different wear scoring. Applying minimum wear criteria of ≥10 h·d -1 for ≥4 d reduced wear fatigue to -5.3 and -18.7 min·d -1 for the wrist and hip, respectively. CONCLUSIONS Patterns of wear suggest noncompliance may disproportionately affect estimates of sleep and sedentary behavior, particularly for adolescents. Further study is needed to determine the effect of wear fatigue on longer assessments.
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Affiliation(s)
- Samuel R Lamunion
- Energy Metabolism Section, National Institute of Diabetes, Digestive and Kidney Diseases, Diabetes, Endocrinology, and Obesity Branch, National Institutes of Health (NIH), Bethesda, MD
| | - Robert J Brychta
- Energy Metabolism Section, National Institute of Diabetes, Digestive and Kidney Diseases, Diabetes, Endocrinology, and Obesity Branch, National Institutes of Health (NIH), Bethesda, MD
| | - Pedro F Saint-Maurice
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Kong Y Chen
- Energy Metabolism Section, National Institute of Diabetes, Digestive and Kidney Diseases, Diabetes, Endocrinology, and Obesity Branch, National Institutes of Health (NIH), Bethesda, MD
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16
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Soni S, Tabatabaei Dakhili SA, Ussher JR, Dyck JRB. The therapeutic potential of ketones in cardiometabolic disease: impact on heart and skeletal muscle. Am J Physiol Cell Physiol 2024; 326:C551-C566. [PMID: 38193855 PMCID: PMC11192481 DOI: 10.1152/ajpcell.00501.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 01/10/2024]
Abstract
β-Hydroxybutyrate (βOHB) is the major ketone in the body, and it is recognized as a metabolic energy source and an important signaling molecule. While ketone oxidation is essential in the brain during prolonged fasting/starvation, other organs such as skeletal muscle and the heart also use ketones as metabolic substrates. Additionally, βOHB-mediated molecular signaling events occur in heart and skeletal muscle cells, and via metabolism and/or signaling, ketones may contribute to optimal skeletal muscle health and cardiac function. Of importance, when the use of ketones for ATP production and/or as signaling molecules becomes disturbed in the presence of underlying obesity, type 2 diabetes, and/or cardiovascular diseases, these changes may contribute to cardiometabolic disease. As a result of these disturbances in cardiometabolic disease, multiple approaches have been used to elevate circulating ketones with the goal of optimizing either ketone metabolism or ketone-mediated signaling. These approaches have produced significant improvements in heart and skeletal muscle during cardiometabolic disease with a wide range of benefits that include improved metabolism, weight loss, better glycemic control, improved cardiac and vascular function, as well as reduced inflammation and oxidative stress. Herein, we present the evidence that indicates that ketone therapy could be used as an approach to help treat cardiometabolic diseases by targeting cardiac and skeletal muscles.
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Affiliation(s)
- Shubham Soni
- Cardiovascular Research Centre, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Seyed Amirhossein Tabatabaei Dakhili
- Cardiovascular Research Centre, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - John R Ussher
- Cardiovascular Research Centre, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Jason R B Dyck
- Cardiovascular Research Centre, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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17
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McNelly A, Langan A, Bear DE, Page A, Martin T, Seidu F, Santos F, Rooney K, Liang K, Heales SJ, Baldwin T, Alldritt I, Crossland H, Atherton PJ, Wilkinson D, Montgomery H, Prowle J, Pearse R, Eaton S, Puthucheary ZA. A pilot study of alternative substrates in the critically Ill subject using a ketogenic feed. Nat Commun 2023; 14:8345. [PMID: 38102152 PMCID: PMC10724188 DOI: 10.1038/s41467-023-42659-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/18/2023] [Indexed: 12/17/2023] Open
Abstract
Bioenergetic failure caused by impaired utilisation of glucose and fatty acids contributes to organ dysfunction across multiple tissues in critical illness. Ketone bodies may form an alternative substrate source, but the feasibility and safety of inducing a ketogenic state in physiologically unstable patients is not known. Twenty-nine mechanically ventilated adults with multi-organ failure managed on intensive care units were randomised (Ketogenic n = 14, Control n = 15) into a two-centre pilot open-label trial of ketogenic versus standard enteral feeding. The primary endpoints were assessment of feasibility and safety, recruitment and retention rates and achievement of ketosis and glucose control. Ketogenic feeding was feasible, safe, well tolerated and resulted in ketosis in all patients in the intervention group, with a refusal rate of 4.1% and 82.8% retention. Patients who received ketogenic feeding had fewer hypoglycaemic events (0.0% vs. 1.6%), required less exogenous international units of insulin (0 (Interquartile range 0-16) vs.78 (Interquartile range 0-412) but had slightly more daily episodes of diarrhoea (53.5% vs. 42.9%) over the trial period. Ketogenic feeding was feasible and may be an intervention for addressing bioenergetic failure in critically ill patients. Clinical Trials.gov registration: NCT04101071.
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Affiliation(s)
- Angela McNelly
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Anne Langan
- Department of Dietetics, Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Danielle E Bear
- Department of Nutrition and Dietetics, St Thomas' NHS Foundation Trust, London, UK
- Department of Critical Care, Guy's and St. Thomas' NHS, London, UK
| | | | - Tim Martin
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Fatima Seidu
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Filipa Santos
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Kieron Rooney
- Department of Critical Care, Bristol Royal Infirmary, Bristol, UK
| | - Kaifeng Liang
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Simon J Heales
- Genetic & Genomic Medicine Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Tomas Baldwin
- Developmental Biology & Cancer, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Isabelle Alldritt
- Centre of Metabolism, Aging & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Aging Research & NIHR Nottingham BRC, University of Nottingham, Nottingham, UK
| | - Hannah Crossland
- Centre of Metabolism, Aging & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Aging Research & NIHR Nottingham BRC, University of Nottingham, Nottingham, UK
| | - Philip J Atherton
- Centre of Metabolism, Aging & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Aging Research & NIHR Nottingham BRC, University of Nottingham, Nottingham, UK
| | - Daniel Wilkinson
- Centre of Metabolism, Aging & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Aging Research & NIHR Nottingham BRC, University of Nottingham, Nottingham, UK
| | - Hugh Montgomery
- University College London (UCL), London, UK
- UCL Hospitals NHS Foundation Trust (UCLH), National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
| | - John Prowle
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Rupert Pearse
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Simon Eaton
- Developmental Biology & Cancer, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Zudin A Puthucheary
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK.
- Adult Critical Care Unit, Royal London Hospital, London, UK.
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18
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Flanagan EW, Spann R, Berry SE, Berthoud HR, Broyles S, Foster GD, Krakoff J, Loos RJF, Lowe MR, Ostendorf DM, Powell-Wiley TM, Redman LM, Rosenbaum M, Schauer PR, Seeley RJ, Swinburn BA, Hall K, Ravussin E. New insights in the mechanisms of weight-loss maintenance: Summary from a Pennington symposium. Obesity (Silver Spring) 2023; 31:2895-2908. [PMID: 37845825 PMCID: PMC10915908 DOI: 10.1002/oby.23905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/18/2023] [Accepted: 08/04/2023] [Indexed: 10/18/2023]
Abstract
Obesity is a chronic disease that affects more than 650 million adults worldwide. Obesity not only is a significant health concern on its own, but predisposes to cardiometabolic comorbidities, including coronary heart disease, dyslipidemia, hypertension, type 2 diabetes, and some cancers. Lifestyle interventions effectively promote weight loss of 5% to 10%, and pharmacological and surgical interventions even more, with some novel approved drugs inducing up to an average of 25% weight loss. Yet, maintaining weight loss over the long-term remains extremely challenging, and subsequent weight gain is typical. The mechanisms underlying weight regain remain to be fully elucidated. The purpose of this Pennington Biomedical Scientific Symposium was to review and highlight the complex interplay between the physiological, behavioral, and environmental systems controlling energy intake and expenditure. Each of these contributions were further discussed in the context of weight-loss maintenance, and systems-level viewpoints were highlighted to interpret gaps in current approaches. The invited speakers built upon the science of obesity and weight loss to collectively propose future research directions that will aid in revealing the complicated mechanisms involved in the weight-reduced state.
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Affiliation(s)
| | - Redin Spann
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Sarah E. Berry
- Department of Nutritional Sciences, King’s College London, London, UK
| | | | | | - Gary D. Foster
- WW International, New York, New York, USA
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology & Clinical Research Branch, NIDDK-Phoenix, Phoenix, Arizona, USA
| | - Ruth J. F. Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Danielle M. Ostendorf
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Leanne M. Redman
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics and Irving Center for Clinical and Translational Research, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Randy J. Seeley
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Boyd A. Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Kevin Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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19
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Bolyard ML, Graziano CM, Fontaine KR, Sayer RD, Fisher G, Plaisance EP. Tolerability and Acceptability of an Exogenous Ketone Monoester and Ketone Monoester/Salt Formulation in Humans. Nutrients 2023; 15:4876. [PMID: 38068734 PMCID: PMC10708260 DOI: 10.3390/nu15234876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Exogenous ketone ester and ketone ester mixed with ketone free acid formulations are rapidly entering the commercial marketspace. Short-term animal and human studies using these products suggest significant potential for primary or secondary prevention of a number of chronic disease conditions. However, a number of questions need to be addressed by the field for optimal use in humans, including variable responses among available exogenous ketones at different dosages; frequency of dosing; and their tolerability, acceptability, and efficacy in long-term clinical trials. The purpose of the current investigation was to examine the tolerability, acceptability, and circulating R-beta-hydroxybutyrate (R-βHB) and glucose responses to a ketone monoester (KME) and ketone monoester/salt (KMES) combination at 5 g and 10 g total R-βHB compared with placebo control (PC). Fourteen healthy young adults (age: 21 ± 2 years, weight: 69.7 ± 14.2 kg, percent fat: 28.1 ± 9.3%) completed each of the five study conditions: placebo control (PC), 5 g KME (KME5), 10 g KME (KME10), 5 g (KMES5), and 10 g KMES (KMES10) in a randomized crossover fashion. Circulating concentrations of R-βHB were measured at baseline (time 0) following an 8-12 h overnight fast and again at 15, 30, 60, and 120 min following drink ingestion. Participants also reported acceptability and tolerability during each condition. Concentrations of R-βHB rose to 2.4 ± 0.1 mM for KME10 after 15 min, whereas KMES10 similarly peaked (2.1 ± 0.1 mM) but at 30 min. KME5 and KMES5 achieved similar peak R-βHB concentrations (1.2 ± 0.7 vs. 1.1 ± 0.5 mM) at 15 min. Circulating R-βHB concentrations were similar to baseline for each condition by 120 min. Negative correlations were observed between R-βHB and glucose at the 30 min time point for each condition except KME10 and PC. Tolerability was similar among KME and KMES, although decreases in appetite were more frequently reported for KMES. Acceptability was slightly higher for KMES due to the more frequently reported aftertaste for KME. The results of this pilot investigation illustrate that the KME and KMES products used increase circulating R-βHB concentrations to a similar extent and time course in a dose-dependent fashion with slight differences in tolerability and acceptability. Future studies are needed to examine variable doses, frequency, and timing of exogenous ketone administration for individuals seeking to consume ketone products for health- or sport performance-related purposes.
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Affiliation(s)
- Mickey L. Bolyard
- Department of Human Studies, School of Education, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (M.L.B.); (C.M.G.); (G.F.)
| | - Christina M. Graziano
- Department of Human Studies, School of Education, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (M.L.B.); (C.M.G.); (G.F.)
| | - Kevin R. Fontaine
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - R. Drew Sayer
- Department of Family and Community Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35924, USA;
| | - Gordon Fisher
- Department of Human Studies, School of Education, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (M.L.B.); (C.M.G.); (G.F.)
| | - Eric P. Plaisance
- Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35924, USA
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20
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Li S, Yuan S, Lin G, Zhang J. Effects of a two meals-a-day ketogenic diet on newly diagnosed obese patients with type 2 diabetes mellitus: A retrospective observational study. Medicine (Baltimore) 2023; 102:e35753. [PMID: 37904380 PMCID: PMC10615408 DOI: 10.1097/md.0000000000035753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/02/2023] [Indexed: 11/01/2023] Open
Abstract
To investigate the effects of a two-meals-a-day energy-restricted ketogenic diet (KD) on newly diagnosed obese patients with type 2 diabetes mellitus. In total, 60 obese patients with newly diagnosed type 2 diabetes mellitus were divided into 2 groups: 1 group followed a 2-meals-a-day KD and the other group followed a conventional diabetic diet. Changes in weight, blood glucose, blood lipids, insulin resistance, and uric acid levels were observed before and after 2 months of adhering to the respective diets under energy restriction. Both groups showed significant reductions in weight, waist circumference, body mass index, total cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, fasting blood glucose, fasting insulin, and glycated hemoglobin (P < .05). The twice-daily KD group showed more significant improvements in these parameters compared to the conventional diabetic diet group. In addition, the 2-meals-a-day KD group showed a slight increase in uric acid levels compared to the conventional diabetic diet control group (P < .05). The 2-meals-a-day KD can significantly improve weight, blood glucose, and lipid control in newly diagnosed obese patients with type 2 diabetes mellitus.
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Affiliation(s)
- Sumei Li
- Department of Endocrinology, The First Hospital of Putian City, Teaching Hospital, Fujian Medical University, Putian, People’s Republic of China
| | - Shouping Yuan
- Department of Endocrinology, The First Hospital of Putian City, Teaching Hospital, Fujian Medical University, Putian, People’s Republic of China
| | - Guoxin Lin
- Department of Endocrinology, The First Hospital of Putian City, Teaching Hospital, Fujian Medical University, Putian, People’s Republic of China
| | - Jintian Zhang
- Department of Pathology, Putian University, Fujian, People’s Republic of China
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21
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Bernard S, Spalding KL. Implication of lipid turnover for the control of energy balance. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220202. [PMID: 37661738 PMCID: PMC10475865 DOI: 10.1098/rstb.2022.0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
The ongoing obesity epidemic is a consequence of a progressive energy imbalance. The energy-balance model (EBM) posits that obesity results from an excess in food intake and circulating fuels. A reversal in causality has been proposed recently in the form of the carbohydrate-insulin model (CIM), according to which fat storage drives energy imbalance. Under the CIM, dietary carbohydrates shift energy use in favour of storage in adipose tissue. The dynamics of lipid storage and mobilization could, therefore, be sensitive to changes in carbohydrate intake and represent a measurable component of the CIM. To characterize potential changes in lipid dynamics induced by carbohydrates, mathematical models were used. Here, we propose a coherent mathematical implementation of the CIM-energy deposition model (CIM-EDM), which includes lipid turnover dynamics. Using lipid turnover data previously obtained by radiocarbon dating, we build two cohorts of virtual patients and simulate lipid dynamics during ageing and weight loss. We identify clinically testable lipid dynamic parameters that discriminate between the CIM-EDM and an energy in, energy out implementation of the EBM (EBM-IOM). Using a clinically relevant two-month virtual trial, we additionally identify scenarios and propose mechanisms whereby individuals may respond differently to low-carbohydrate diets. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'.
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Affiliation(s)
- S. Bernard
- Institut Camille Jordan, CNRS, University of Lyon and Inria, Villeurbanne, 69603, France
| | - K. L. Spalding
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, 17177, Sweden
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22
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Hengist A, Sciarrillo CM, Guo J, Walter M, Hall KD. Discordance between gut-derived appetite hormones and energy intake in humans. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.10.23289718. [PMID: 37425848 PMCID: PMC10327278 DOI: 10.1101/2023.05.10.23289718] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Gut-derived hormones affect appetite and are thought to play an important role in body weight regulation. Dietary macronutrient composition can influence gut-derived appetite hormone concentrations, thereby providing theoretical basis for why some diets might facilitate weight loss better than others. We investigated postprandial gut-derived appetite hormones in 20 inpatient adults after 2 weeks of eating either a low carbohydrate (LC) or a low fat (LF) diet followed by the alternate diet in random order. A LC meal resulted in significantly greater postprandial GLP-1, GIP, and PYY but lower ghrelin compared to an isocaloric LF meal (all p≤0.02). However, differences in gut-derived appetite hormones were incommensurate with subsequent ad libitum energy intake over the rest of the day, which was 551±103 kcal (p<0.0001) greater with the LC as compared to the LF diet. The effects of gut-derived appetite hormones on ad libitum energy intake can be dominated by other diet-related factors, at least in the short-term.
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Affiliation(s)
- Aaron Hengist
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
| | - Christina M. Sciarrillo
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
| | - Juen Guo
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
| | - Mary Walter
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
| | - Kevin D. Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD, 20892, USA
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23
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Di Lauro M, Guerriero C, Cornali K, Albanese M, Costacurta M, Mercuri NB, Di Daniele N, Noce A. Linking Migraine to Gut Dysbiosis and Chronic Non-Communicable Diseases. Nutrients 2023; 15:4327. [PMID: 37892403 PMCID: PMC10609600 DOI: 10.3390/nu15204327] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/02/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
In the world, migraine is one of the most common causes of disability in adults. To date, there is no a single cause for this disorder, but rather a set of physio-pathogenic triggers in combination with a genetic predisposition. Among the factors related to migraine onset, a crucial role seems to be played by gut dysbiosis. In fact, it has been demonstrated how the intestine is able to modulate the central nervous system activities, through the gut-brain axis, and how gut dysbiosis can influence neurological pathologies, including migraine attacks. In this context, in addition to conventional pharmacological treatments for migraine, attention has been paid to an adjuvant therapeutic strategy based on different nutritional approaches and lifestyle changes able to positively modulate the gut microbiota composition. In fact, the restoration of the balance between the different gut bacterial species, the reconstruction of the gut barrier integrity, and the control of the release of gut-derived inflammatory neuropeptides, obtained through specific nutritional patterns and lifestyle changes, represent a possible beneficial additive therapy for many migraine subtypes. Herein, this review explores the bi-directional correlation between migraine and the main chronic non-communicable diseases, such as diabetes mellitus, arterial hypertension, obesity, cancer, and chronic kidney diseases, whose link is represented by gut dysbiosis.
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Affiliation(s)
- Manuela Di Lauro
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
| | - Cristina Guerriero
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
| | - Kevin Cornali
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
| | - Maria Albanese
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
- Neurology Unit, Headache Center, Tor Vergata University Hospital, 00133 Rome, RM, Italy
| | - Micaela Costacurta
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, RM, Italy;
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
- Neurology Unit, Headache Center, Tor Vergata University Hospital, 00133 Rome, RM, Italy
| | - Nicola Di Daniele
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
- Fondazione Leonardo per le Scienze Mediche Onlus, Policlinico Abano, 35031 Abano Terme, PD, Italy
| | - Annalisa Noce
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
- UOSD Nephrology and Dialysis, Policlinico Tor Vergata, 00133 Rome, RM, Italy
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24
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Sciarrillo CM, Guo J, Hengist A, Darcey VL, Hall KD. Diet order affects energy balance in randomized crossover feeding studies that vary in macronutrients but not ultra-processing. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.03.23296501. [PMID: 37986904 PMCID: PMC10659501 DOI: 10.1101/2023.10.03.23296501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
BACKGROUND Crossover studies can induce order effects, especially when they lack a wash-out period. OBJECTIVE To explore diet order effects on energy balance and food intake between randomized diet order groups in two inpatient crossover studies originally designed to compare within-subject differences in ad libitum energy intake between either minimally processed low carbohydrate (LC) versus low fat (LF) diets or macronutrient-matched diets composed of mostly minimally processed food (MPF) or ultra-processed food (UPF). METHODS Diet order group comparisons of changes in body weight, body composition, and differences in energy expenditure, and food intake were assessed over four weeks in 20 adults randomized to either the LC followed immediately by the LF diet (LC→LF) or the opposite order (LF→LC) as well as 20 adults randomized to either the MPF followed by UPF (MPF→UPF) diets or the opposite order (UPF→MPF). RESULTS Subjects randomized to LC→LF lost 2.9 ± 1.1 kg more body weight (p < 0.001) and 1.5 ± 0.6 kg more body fat (p = 0.03) than the LF→LC group likely because the LC→LF group consumed 922 ± 304 kcal/d less than the LF→LC group (p = 0.0024). Reduced energy intake in LC→LF vs LF→LC was driven by the last two weeks (-1610 ± 306 kcal/d; p<0.00001) perhaps due to carryover effects of gut adaptations over the first two weeks arising from large differences in the mass of food (1295 ± 209 g/d; p<0.00001) and fiber intake (58 ± 5 g/d; p<0.00001). There were no diet order effects on ad libitum energy intake, body weight, or body composition change between UPF→MPF versus MPF→UPF groups. CONCLUSIONS Diet order influences daily ad libitum energy intake, body weight change, and fat change within the context of a 4-week crossover inpatient diet study varying in macronutrients, but not varying in extent and purpose of processing. Funding sources Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. Clinical Trial Registration NCT03407053 and NCT03878108.
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Affiliation(s)
| | - Juen Guo
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Aaron Hengist
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Valerie L. Darcey
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Kevin D. Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
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25
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Fernández-Verdejo R, Mey JT, Ravussin E. Effects of ketone bodies on energy expenditure, substrate utilization, and energy intake in humans. J Lipid Res 2023; 64:100442. [PMID: 37703994 PMCID: PMC10570604 DOI: 10.1016/j.jlr.2023.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023] Open
Abstract
The potential of ketogenic approaches to regulate energy balance has recently gained attention since ketones may influence both energy expenditure and energy intake. In this narrative review, we summarized the most relevant evidence about the role of ketosis on energy expenditure, substrate utilization, and energy intake in humans. We considered different strategies to induce ketosis, such as fasting, dietary manipulation, and exogenous ketone sources. In general, ketosis does not have a major influence on energy expenditure but promotes a shift in substrate utilization towards ketone body oxidation. The strategies to induce ketosis by reduction of dietary carbohydrate availability (e.g., ketogenic diets) do not independently influence energy intake, being thus equally effective for weight loss as diets with higher carbohydrate content. In contrast, the intake of medium-chain triglycerides and ketone esters induces ketosis and appears to increase energy expenditure and reduce energy intake in the context of high carbohydrate availability. These latter strategies lead to slightly enhanced weight loss. Unfortunately, distinguishing the effects of the various ketogenic strategies per se from the effects of other physiological responses is not possible with the available human data. Highly controlled, inpatient studies using targeted strategies to isolate the independent effects of ketones are required to adequately address this knowledge gap.
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Affiliation(s)
- Rodrigo Fernández-Verdejo
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA; Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Jacob T Mey
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.
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26
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Zandvakili I, Pulaski M, Pickett-Blakely O. A phenotypic approach to obesity treatment. Nutr Clin Pract 2023; 38:959-975. [PMID: 37277855 DOI: 10.1002/ncp.11013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/23/2023] [Accepted: 04/16/2023] [Indexed: 06/07/2023] Open
Abstract
Obesity is a chronic disease that increases morbidity and mortality and adversely affects quality of life. The rapid rise of obesity has outpaced the development and deployment of effective therapeutic interventions, thereby creating a global health crisis. The presentation, complications, and response to obesity treatments vary, yet lifestyle modification, which is the foundational therapeutic intervention for obesity, is often "one size fits all." The concept of personalized medicine uses genetic and phenotypic information as a guide for disease prevention, diagnosis, and treatment and has been successfully applied in diseases such as cancer, but not in obesity. As we gain insight into the pathophysiologic mechanisms of obesity and its phenotypic expression, specific pathways can be targeted to yield a greater, more sustained therapeutic impact in an individual patient with obesity. A phenotype-based pharmacologic treatment approach utilizing objective measures to classify patients into predominant obesity mechanism groups resulted in greater weight loss (compared with a non-phenotype-based approach) in a recent study by Acosta and colleagues. In this review, we discuss the application of lifestyle modifications, behavior therapy and pharmacotherapy using the obesity phenotype-based approach as a framework.
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Affiliation(s)
- Inuk Zandvakili
- Division of Digestive Diseases, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Gastroenterology and Hepatology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Marya Pulaski
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Octavia Pickett-Blakely
- Division of Gastroenterology and Hepatology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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27
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Da Eira D, Jani S, Stefanovic M, Ceddia RB. The ketogenic diet promotes triacylglycerol recycling in white adipose tissue and uncoupled fat oxidation in brown adipose tissue, but does not reduce adiposity in rats. J Nutr Biochem 2023; 120:109412. [PMID: 37422170 DOI: 10.1016/j.jnutbio.2023.109412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/06/2023] [Accepted: 07/03/2023] [Indexed: 07/10/2023]
Abstract
The purpose of this study was to determine whether the weight-reducing and fat burning effects of the ketogenic diet (KD) could be attributed to alterations in the energy dissipating pathways of brown adipose tissue (BAT) uncoupled oxidation, and white adipose tissue (WAT) browning and triacylglycerol (TAG) recycling. To investigate this, male Wistar rats were fed one of the following three diets for either 8 or 16 weeks: a standard chow (SC), a high-fat, sucrose-enriched (HFS) obesogenic diet, or a KD. At the end of the intervention, subcutaneous inguinal (Sc Ing) and epididymal (Epid) fat, and interscapular and aortic BAT (iBAT and aBAT, respectively) were extracted. These tissues were used for the analysis of proteins involved in WAT browning and thermogenesis. Isolated adipocytes from WAT were assayed for basal and isoproterenol (Iso)-stimulated lipolysis and basal and insulin-stimulated lipogenesis, and BAT adipocytes were assayed for the determination of coupled and uncoupled glucose and palmitate oxidation. Adiposity similarly increased in HFS- and KD-fed rats at weeks 8 and 16. However, in HFS-fed animals insulin-stimulated lipogenesis and Iso-stimulated lipolysis were impaired in WAT adipocytes, whereas in KD-fed animals these pathways remained intact. The KD also significantly elevated WAT glycerol kinase levels, and favored TAG recycling under conditions of enhanced lipolysis. In BAT, the KD significantly increased uncoupling protein-1 levels and uncoupled fat oxidation. In summary, the KD preserved insulin sensitivity and lipolytic capacity in WAT and also upregulated energy-dissipating pathways in BAT, but it was not sufficient to prevent an increase in adiposity.
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Affiliation(s)
- Daniel Da Eira
- Muscle Health Research Centre - School of Kinesiology and Health Science, York University, North York, ON, Canada
| | - Shailee Jani
- Muscle Health Research Centre - School of Kinesiology and Health Science, York University, North York, ON, Canada
| | - Mateja Stefanovic
- Muscle Health Research Centre - School of Kinesiology and Health Science, York University, North York, ON, Canada
| | - Rolando B Ceddia
- Muscle Health Research Centre - School of Kinesiology and Health Science, York University, North York, ON, Canada.
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28
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Li S, Du Y, Meireles C, Sharma K, Qi L, Castillo A, Wang J. Adherence to ketogenic diet in lifestyle interventions in adults with overweight or obesity and type 2 diabetes: a scoping review. Nutr Diabetes 2023; 13:16. [PMID: 37709770 PMCID: PMC10502148 DOI: 10.1038/s41387-023-00246-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/20/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND/OBJECTIVES Despite the evidence supporting the efficacy of the ketogenic diet (KD) on weight and type 2 diabetes (T2D) management, adherence to the KD is challenging. Additionally, no studies have reported changes in PA among individuals with overweight/obesity and T2D who have followed KD. We mapped out the methods used to assess adherence to the KD and level of physical activity (PA) in lifestyle interventions for weight and T2D management in individuals with overweight/obesity and T2D and compared levels of KD adherence and PA in these interventions. METHODS Articles published between January 2005 and March 2022 were searched in MEDLINE, CINAHL, and Scopus. Studies that included KD in lifestyle interventions for adults with T2D and overweight/obesity and measured ketone levels were included. RESULTS The eleven included studies comprised eight randomized controlled trials. They mainly used self-reported measures to evaluate adherence to the KD and level of PA. We found studies reported higher carbohydrate intake and lower fat intake than the KD regimen. Great inconsistencies were found among studies on the measurement and reporting of ketone and PA levels. CONCLUSION Our results demonstrated the need to develop intervention strategies to improve adherence to the KD, as well as the necessity of developing standardized diet and PA assessment tools to establish a stronger evidence base for including KD in lifestyle interventions for weight and T2D management among adults with overweight/obesity and T2D.
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Affiliation(s)
- Shiyu Li
- School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Yan Du
- School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | | | - Kumar Sharma
- Center for Precision Medicine, Long School of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | | | - Jing Wang
- College of Nursing, Florida State University, Tallahassee, FL, USA.
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Eid SA, O’Brien PD, Kretzler KH, Jang DG, Mendelson FE, Hayes JM, Carter A, Zhang H, Pennathur S, Brosius FC, Koubek EJ, Feldman EL. Dietary interventions improve diabetic kidney disease, but not peripheral neuropathy, in a db/db mouse model of type 2 diabetes. FASEB J 2023; 37:e23115. [PMID: 37490006 PMCID: PMC10372884 DOI: 10.1096/fj.202300354r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/05/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
Patients with type 2 diabetes often develop the microvascular complications of diabetic kidney disease (DKD) and diabetic peripheral neuropathy (DPN), which decrease quality of life and increase mortality. Unfortunately, treatment options for DKD and DPN are limited. Lifestyle interventions, such as changes to diet, have been proposed as non-pharmacological treatment options for preventing or improving DKD and DPN. However, there are no reported studies simultaneously evaluating the therapeutic efficacy of varying dietary interventions in a type 2 diabetes mouse model of both DKD and DPN. Therefore, we compared the efficacy of a 12-week regimen of three dietary interventions, low carbohydrate, caloric restriction, and alternate day fasting, for preventing complications in a db/db type 2 diabetes mouse model by performing metabolic, DKD, and DPN phenotyping. All three dietary interventions promoted weight loss, ameliorated glycemic status, and improved DKD, but did not impact percent fat mass and DPN. Multiple regression analysis identified a negative correlation between fat mass and motor nerve conduction velocity. Collectively, our data indicate that these three dietary interventions improved weight and glycemic status and alleviated DKD but not DPN. Moreover, diets that decrease fat mass may be a promising non-pharmacological approach to improve DPN in type 2 diabetes given the negative correlation between fat mass and motor nerve conduction velocity.
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Affiliation(s)
- Stephanie A. Eid
- Department of Neurology, University of Michigan, Ann Arbor, MI 48103, USA
| | | | | | - Dae-Gyu Jang
- Department of Neurology, University of Michigan, Ann Arbor, MI 48103, USA
| | - Faye E. Mendelson
- Department of Neurology, University of Michigan, Ann Arbor, MI 48103, USA
| | - John M. Hayes
- Department of Neurology, University of Michigan, Ann Arbor, MI 48103, USA
| | - Andrew Carter
- Department of Neurology, University of Michigan, Ann Arbor, MI 48103, USA
| | - Hongyu Zhang
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48103, USA
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48103, USA
| | - Subramaniam Pennathur
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48103, USA
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48103, USA
| | - Frank C. Brosius
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48103, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48103, USA
- Department of Medicine, University of Arizona, Tucson, AZ, 85721 USA
| | - Emily J. Koubek
- Department of Neurology, University of Michigan, Ann Arbor, MI 48103, USA
| | - Eva L. Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI 48103, USA
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Paoli A, Bianco A, Moro T, Mota JF, Coelho-Ravagnani CF. The Effects of Ketogenic Diet on Insulin Sensitivity and Weight Loss, Which Came First: The Chicken or the Egg? Nutrients 2023; 15:3120. [PMID: 37513538 PMCID: PMC10385501 DOI: 10.3390/nu15143120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
The ketogenic diet (KD) is, nowadays, considered an interesting nutritional approach for weight loss and improvement in insulin resistance. Nevertheless, most of the studies available in the literature do not allow a clear distinction between its effects on insulin sensitivity per se, and the effects of weight loss induced by KDs on insulin sensitivity. In this review, we discuss the scientific evidence on the direct and weight loss mediated effects of KDs on glycemic status in humans, describing the KD's biochemical background and the underlying mechanisms.
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Affiliation(s)
- Antonio Paoli
- Department of Biomedical Sciences, University of Padua, 35127 Padua, Italy
- Research Center for High Performance Sport, UCAM, Catholic University of Murcia, 30107 Murcia, Spain
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, University of Palermo, 90144 Palermo, Italy
| | - Tatiana Moro
- Department of Biomedical Sciences, University of Padua, 35127 Padua, Italy
| | - Joao Felipe Mota
- School of Nutrition, Federal University of Goiás, Goiânia 74605-080, Brazil
- APC Microbiome Ireland, Department of Medicine, School of Microbiology, University College Cork, T12 YT20 Cork, Ireland
| | - Christianne F Coelho-Ravagnani
- Research in Exercise and Nutrition in Health and Sports Performance-PENSARE, Post-Graduate Program in Movement Sciences, Institute of Health (INISA), Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
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Li W, Hu JK, Hu MG. CDK6: an attractive therapeutic target for T-ALL/LBL. Expert Opin Ther Targets 2023; 27:1087-1096. [PMID: 37975616 DOI: 10.1080/14728222.2023.2285775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/16/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Human T-cell acute lymphoblastic leukemia/T-cell lymphoblastic lymphoma (T-ALL/LBL) is a type of cancer that originates from the bone marrow and spreads quickly to other organs. Long-term survival rate with current available chemotherapy is less than 20%. Despite the potentially huge market, a truly effective and safe therapy for T-ALL/LBL is elusive. Thus, it is imperative to identify new therapeutic ways to target essential pathways in T-ALL that regulate the proliferation and survival of these cancer cells. AREAS COVERED The role of the Cyclin-dependent kinase 6 (CDK6) pathway in human T-ALL is of significant interest with major clinical/translational relevance. This review covers the recent advances in elucidating the essential roles of CDK6 and its closely regulated networks in proliferation, survival, and metabolism of T-ALL cells, with new insight into its mechanisms of action which hopefully could trigger the identification of new therapeutic avenues. EXPERT OPINION Animal models showed that inhibition of CDK6 and its related networks blocked initiation, growth, and survival of T-ALL in vivo. Numerous clinical trials of CDK4/6 inhibitors are ongoing in T-ALL. Specific CDK6 inhibitors alone or novel combination regimens may hopefully delay the progression, or even reverse the symptoms of T-ALL, leading to disease eradication and cure.
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Affiliation(s)
- Wei Li
- Department of Medicine, Division of Hematology and Oncology, Tufts Medical Center, Boston, USA
| | - Jamie Katy Hu
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Miaofen G Hu
- Department of Medicine, Division of Hematology and Oncology, Tufts Medical Center, Boston, USA
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Martins C, Nymo S, Aukan MI, Roekenes JA, Coutinho SR, Hunter GR, Gower BA. Association between ß-Hydroxybutyrate Plasma Concentrations after Hypocaloric Ketogenic Diets and Changes in Body Composition. J Nutr 2023; 153:1944-1949. [PMID: 37182692 DOI: 10.1016/j.tjnut.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Early studies show that ketogenic diets (KDs) lead to preferential loss of fat mass (FM), whereas preserving fat-free mass (FFM). Additionally, animal data support the anticatabolic effects of DL-3-hydroxybutyrate. From our knowledge, a potential association between ß-hydroxybutyrate (ßHB) plasma concentrations and changes in body composition has never been explored. OBJECTIVES The main aim of this analysis was to determine if ßHB plasma concentrations, following hypocaloric KDs, were associated with FM and FFM changes in men and women with obesity. METHODS Data from 199 individuals (BMI = 36.6 ± 4.3 kg/m2; age = 43.6 ± 9.8 y; 82 men) were collated from 3 weight loss studies employing common measures of body composition (air displacement plethysmography) and ßHB plasma concentration (ELISA). The association between ßHB and weight, FM and FFM loss (kg), and %FFM loss (%FFML) was investigated with Spearman correlation. Multivariable linear regression was used to determine if ßHB was a significant predictor of the changes in anthropometric variables, after adjusting for confounding factors. RESULTS ßHB was not associated with FFML (% or kg), but a weak positive association was seen with FM loss (r = 0.182, P = 0.01, n = 199) and a trend with weight loss (r = 0.128, P = 0.072, n = 199). ßHB was a significant predictor of both weight and FM loss (kg), after adjusting for age, sex, baseline BMI, and intervention study. CONCLUSIONS The magnitude of ketosis is not associated with FFM preservation. However, the higher the level of ketosis, the greater the weight and FM loss. Further studies are needed to confirm these findings and to explore the mechanisms involved. This trial was registered at clinicaltrials.gov identifier as NCT01834859, NCT04051190, NCT02944253.
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Affiliation(s)
- Catia Martins
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, Unites States; Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.
| | - Siren Nymo
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Nord-Trøndelag Hospital Trust, Clinic of Surgery, Namsos Hospital, Namsos, Norway
| | - Marthe I Aukan
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jessica A Roekenes
- Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Gary R Hunter
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, Unites States
| | - Barbara A Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, Unites States
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Monsalves-Álvarez M, Jiménez T, Bunout D, Barrera G, Hirsch S, Sepúlveda-Guzman C, Silva C, Rodriguez JM, Troncoso R, de la Maza MP. High-intensity interval training prevents muscle mass loss in overweight Chilean young adults during a hypocaloric-Mediterranean diet: a randomized trial. Front Nutr 2023; 10:1181436. [PMID: 37360303 PMCID: PMC10287981 DOI: 10.3389/fnut.2023.1181436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/21/2023] [Indexed: 06/28/2023] Open
Abstract
The hypocaloric Mediterranean diet (MD) mainly reduces fat mass but inevitably causes a loss of skeletal muscle mass. High-intensity interval training (HIIT) seems to have advantages in preserving muscle mass during a hypocaloric regime. Our study compares body composition and metabolic changes in overweight and obese Chilean women and men after 3 months of weight loss treatment with a Mediterranean-type hypocaloric diet, HIIT, or a combination of both. The study included 83 overweight or obese women and men between the ages of 25 and 50. The subjects were randomly assigned to one of the three intervention groups: (1) MD, (2) EX, and (3) MD + EX. Baseline and post-intervention measurements included: (a) body composition by dual-beam densitometry, muscle, and fat measurements by thigh ultrasound and computed tomography; (b) handgrip and quadriceps muscle strength; (c) exercise performance by peak oxygen consumption, peak load, work efficiency, and exercise energy expenditure; and (d) metabolic parameters. Out of 83 participants, the retention rate was 49% due to low compliance with the interventions. As expected, the MD group resulted in significantly greater weight loss (MD -7%, EX -0.6% and MD + EX -5.3%) and appendicular fat mass loss (MD -11.1%, EX -2.9, MD + EX -10.2%) but was associated with significant lean tissue loss (2.8%), which was prevented by HIIT (EX -0.1 and MD + EX -0.6%). Metabolic and glycoxidative parameters remained unchanged, irrespective of changes in body composition. Hypocaloric diets remain the most effective means to lose weight and body fat. However, it induces a loss of lean body mass when not accompanied by exercise training. This study shows that HIIT prevents the loss of muscle mass caused by a hypocaloric Mediterranean diet.
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Affiliation(s)
| | - Teresa Jiménez
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Daniel Bunout
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Gladys Barrera
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Sandra Hirsch
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Carlos Sepúlveda-Guzman
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
- Laboratorio de Ciencias del Ejercicio, Clínica MEDS, Santiago, Chile
| | | | - Juan M. Rodriguez
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Rodrigo Troncoso
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile, Santiago, Chile
| | - María Pía de la Maza
- Laboratorio de Investigación en Nutrición y Actividad Física (LABINAF), Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
- Clínica Alemana, Santiago, Chile
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Pepe RB, Lottenberg AM, Fujiwara CTH, Beyruti M, Cintra DE, Machado RM, Rodrigues A, Jensen NSO, Caldas APS, Fernandes AE, Rossoni C, Mattos F, Motarelli JHF, Bressan J, Saldanha J, Beda LMM, Lavrador MSF, Del Bosco M, Cruz P, Correia PE, Maximino P, Pereira S, Faria SL, Piovacari SMF. Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022). Diabetol Metab Syndr 2023; 15:124. [PMID: 37296485 PMCID: PMC10251611 DOI: 10.1186/s13098-023-01037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/23/2023] [Indexed: 06/12/2023] Open
Abstract
Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.
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Affiliation(s)
- Renata Bressan Pepe
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | - Ana Maria Lottenberg
- Laboratório de Lipides (LIM10), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
- Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), Rua Mato Grosso 306 – cj 1711, Sao Paulo, SP 01239-040 Brazil
| | - Clarissa Tamie Hiwatashi Fujiwara
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | - Mônica Beyruti
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Dennys Esper Cintra
- Centro de Estudos em Lipídios e Nutrigenômica – CELN – University of Campinas, Campinas, SP Brazil
| | - Roberta Marcondes Machado
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
| | - Alessandra Rodrigues
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Natália Sanchez Oliveira Jensen
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
| | | | - Ariana Ester Fernandes
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | - Carina Rossoni
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Fernanda Mattos
- Programa de Obesidade e Cirurgia Bariátrica do Hospital Universitário Clementino Fraga Filho da UFRJ, Rio de Janeiro, RJ Brazil
| | - João Henrique Fabiano Motarelli
- Núcleo de Estudos e Extensão em Comportamento Alimentar e Obesidade (NEPOCA) da Universidade de São Paulo - FMRP/USP, Ribeirão Preto, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, MG Brazil
| | | | - Lis Mie Masuzawa Beda
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Maria Sílvia Ferrari Lavrador
- Liga Acadêmica de Controle de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP Brazil
| | - Mariana Del Bosco
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, SP Brazil
| | - Patrícia Cruz
- Grupo de Obesidade e Sindrome Metabolica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP Brazil
| | | | - Priscila Maximino
- Instituto PENSI - Fundação José Luiz Egydio Setúbal, Instituto Pensi, Fundação José Luiz Egydio Setúbal, Hospital Infantil Sabará, São Paulo, SP Brazil
| | - Silvia Pereira
- Núcleo de Saúde Alimentar da Sociedade Brasileira de Cirurgia Bariátrica e Metabólica, São Paulo, Brazil
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Hägele FA, Dörner R, Koop J, Lübken M, Seidel U, Rimbach G, Müller MJ, Bosy-Westphal A. Impact of one-day fasting, ketogenic diet or exogenous ketones on control of energy balance in healthy participants. Clin Nutr ESPEN 2023; 55:292-299. [PMID: 37202059 DOI: 10.1016/j.clnesp.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/02/2023] [Accepted: 03/23/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND & AIMS Oral ketone supplements may mimic the beneficial effects of endogenous ketones on energy metabolism as β-hydroxybutyrate has been proposed to increase energy expenditure and improve body weight regulation. Therefore, our objective was to compare the effects of a one-day isocaloric ketogenic diet, fasting and supplementation with ketone salts on energy expenditure and appetite perception. METHODS Eight healthy young adults (4 women, 4 men, age 24 ± 3 years, BMI 24.3 ± 3.1 kg/m2) participated in a randomized cross-over trial with four 24 h-interventions in a whole room indirect calorimeter at a physical activity level of 1.65: (i) total fasting (FAST), (ii) isocaloric ketogenic diet (3.1% energy from carbohydrates (CHO), KETO), (iii) isocaloric control diet (47.4% energy from CHO, ISO), and (iv) ISO supplemented with 38.7 g/d ketone salts (exogenous ketones, EXO). Effects on serum ketone levels (15 h-iAUC), energy metabolism (total energy expenditure, TEE; sleeping energy expenditure, SEE; macronutrient oxidation) and subjective appetite were measured. RESULTS Compared to ISO, ketone levels were considerably higher with FAST and KETO and little higher with EXO (all p > 0.05). Total and sleeping energy expenditure did not differ between ISO, FAST and EXO whereas KETO increased TEE (+110 ± 54 kcal/d vs. ISO, p < 0.05) and SEE (+201 ± 90 kcal/d vs. ISO, p < 0.05). CHO oxidation was slightly decreased with EXO compared to ISO (-48 ± 27 g/d, p < 0.05) resulting in a positive CHO balance (p < 0.05). No differences between the interventions were found for subjective appetite ratings (all p > 0.05). CONCLUSION A 24 h-ketogenic diet may contribute to maintain a neutral energy balance by increasing energy expenditure. Exogenous ketones in addition to an isocaloric diet did not improve regulation of energy balance. CLINICAL TRIAL REGISTRATION NCT04490226 https://clinicaltrials.gov/.
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Affiliation(s)
- Franziska A Hägele
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Rebecca Dörner
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Jana Koop
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Marie Lübken
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Ulrike Seidel
- Department of Food Sciences, Institute of Human Nutrition and Food Sciences, Kiel University, Hermann-Rodewald-Strasse 6, 24098 Kiel, Germany
| | - Gerald Rimbach
- Department of Food Sciences, Institute of Human Nutrition and Food Sciences, Kiel University, Hermann-Rodewald-Strasse 6, 24098 Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany.
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Gagnon E, Mitchell PL, Arsenault BJ. Body Fat Distribution, Fasting Insulin Levels, and Insulin Secretion: A Bidirectional Mendelian Randomization Study. J Clin Endocrinol Metab 2023; 108:1308-1317. [PMID: 36585897 DOI: 10.1210/clinem/dgac758] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/07/2022] [Accepted: 12/28/2022] [Indexed: 01/01/2023]
Abstract
CONTEXT Hyperinsulinemia and adiposity are associated with one another, but the directionality of this relation is debated. OBJECTIVE Here, we tested the direction of the causal effects of fasting insulin (FI) levels and body fat accumulation/distribution using 2-sample bidirectional Mendelian randomization (MR). METHODS We included summary statistics from large-scale genome-wide association studies for body mass index (BMI, n = 806 834), waist to hip ratio adjusted for BMI (WHRadjBMI, n = 694 649), abdominal subcutaneous, visceral and gluteofemoral adipose tissue (n = 38 965), FI levels (n = 98 210), pancreatic islets gene expression (n = 420), and hypothalamus gene expression (n = 155). We used inverse variance-weighted and robust MR methods that relied on statistically and biologically driven genetic instruments. RESULTS Both BMI and WHRadjBMI were positively associated with FI. Results were consistent across all robust MR methods and when variants mapped to the hypothalamus (presumably associated with food behavior) were included. In multivariable MR analyses, when waist circumference and BMI were mutually adjusted, the direct effect of waist circumference on FI was 2.43 times larger than the effect of BMI on FI. FI was not associated with adiposity. By contrast, using genetic instruments mapped to gene expression in pancreatic islets (presumably more specific to insulin secretion), insulin was positively associated with BMI and abdominal subcutaneous and gluteofemoral adipose tissue, but not with visceral adipose tissue. CONCLUSION Although these results will need to be supported by experimental investigations, results of this MR study suggest that abdominal adiposity may be a key determinant of circulating insulin levels. Alternatively, insulin secretion may promote peripheral adipose tissue accumulation.
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Affiliation(s)
- Eloi Gagnon
- Quebec Heart and Lung Institute, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC G1V 4G5, Canada
| | - Patricia L Mitchell
- Quebec Heart and Lung Institute, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC G1V 4G5, Canada
| | - Benoit J Arsenault
- Quebec Heart and Lung Institute, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC G1V 4G5, Canada
- Department of Medicine, Faculty of Medicine, Université Laval, Québec, QC G1V 5C3, Canada
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Kawasaki Y, Kitamura E, Kasai T. Impact of Body Composition on Sleep and Its Relationship with Sleep Disorders: Current Insights. Nat Sci Sleep 2023; 15:375-388. [PMID: 37220427 PMCID: PMC10200107 DOI: 10.2147/nss.s340946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/04/2023] [Indexed: 05/25/2023] Open
Abstract
Sleep is involved in many physiological processes and is essential for both physical and mental health. Obesity and sleep deprivation due to sleep disorders are major public health issues. Their incidence is increasing, and they have a wide range of adverse health-related consequences, including life-threatening cardiovascular disease. The impact of sleep on obesity and body composition is well-known, and many studies have shown an association between insufficient or excessive sleep duration and obesity, body fat percentage, and weight gain. However, there is growing evidence of the effects of body composition on sleep and sleep disorders (particularly sleep disordered breathing) through anatomical and physiological mechanisms (nocturnal fluid shift, core body temperature, or diet). Although some research has been conducted on the bidirectional effects of sleep-disordered breathing and body composition, the specific effects of obesity and body composition on sleep and the underlying mechanisms that explain these effects remain unclear. Therefore, this review summarizes the findings on the effects of body composition on sleep and draws conclusions and proposals for future research in this field.
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Affiliation(s)
- Yu Kawasaki
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Eri Kitamura
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan
- Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Cardiovascular Management and Remote Monitoring, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Miksza U, Adamska-Patruno E, Bauer W, Fiedorczuk J, Czajkowski P, Moroz M, Drygalski K, Ustymowicz A, Tomkiewicz E, Gorska M, Kretowski A. Obesity-related parameters in carriers of some BDNF genetic variants may depend on daily dietary macronutrients intake. Sci Rep 2023; 13:6585. [PMID: 37085692 PMCID: PMC10121660 DOI: 10.1038/s41598-023-33842-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/19/2023] [Indexed: 04/23/2023] Open
Abstract
Some common single-nucleotide polymorphisms of the brain-derived neurotrophic factor (BDNF) gene have been associated not only with the neurodegenerative diseases but also with some eating disorders. The aim of this study was to assess the possible differences in the obesity-related and glucose metabolism parameters between some BDNF genotypes', that may depend on the daily energy and macronutrients intake. In 484 adult participants we performed the anthropometric measurements, body composition analysis, and body fat distribution. The daily dietary intake was assessed using the 3-day food intake diaries. Blood glucose and insulin concentrations were measured at fasting and during oral glucose tolerance tests. Moreover, the visceral adipose tissue/subcutaneous adipose tissue (VAT/SAT) ratio and homeostatic model assessment of insulin resistance were calculated. We noted that participants carrying the GG genotype had lower skeletal muscle mass and fat free mass (FFM) when carbohydrate intake was > 48%, whereas they presented higher fat-free mass (FFM), and surprisingly higher total cholesterol and LDL-C concentrations when daily fiber intake was > 18 g. Moreover, in these subjects we noted higher waist circumference, BMI, and fasting glucose and insulin concentrations, when > 18% of total daily energy intake was delivered from proteins, and higher VAT content and HDL-C concentrations when > 30% of energy intake was derived from dietary fat. Our results suggest that glucose homeostasis and obesity-related parameters in carriers of some common variants of BDNF gene, especially in the GG (rs10835211) genotype carriers, may differ dependently on daily energy, dietary macronutrients and fiber intake.
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Affiliation(s)
- Urszula Miksza
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland.
- Clinical Research Support Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland.
| | - Edyta Adamska-Patruno
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland.
- Clinical Research Support Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland.
| | - Witold Bauer
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Joanna Fiedorczuk
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Przemyslaw Czajkowski
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Monika Moroz
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Krzysztof Drygalski
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Andrzej Ustymowicz
- Department of Radiology, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Elwira Tomkiewicz
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Maria Gorska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Adam Kretowski
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
- Clinical Research Support Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
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Rushing KA, Bolyard ML, Kelty T, Wieschhaus N, Pavela G, Rector RS, Plaisance EP. Dietary ketone ester attenuates the accretion of adiposity and liver steatosis in mice fed a high-fat, high-sugar diet. Front Physiol 2023; 14:1165224. [PMID: 37113697 PMCID: PMC10128912 DOI: 10.3389/fphys.2023.1165224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023] Open
Abstract
Objective: The ketone diester, R,S-1,3-butanediol diacetoacetate (BD-AcAc2), attenuates the accretion of adiposity and reduces hepatic steatosis in high-fat diet-induced obese mice when carbohydrate energy is removed from the diet to accommodate energy from the ester. Reducing carbohydrate energy is a potential confounder due to the well-known effects of carbohydrate restriction on components of energy balance and metabolism. Therefore, the current investigation was designed to determine whether the addition of BD-AcAc2 to a high-fat, high-sugar diet (with no reduction in carbohydrate energy) would attenuate the accretion of adiposity and markers of hepatic steatosis and inflammation. Methods: Sixteen 11-week-old male C57BL/6J mice were randomized to one of two groups for 9 weeks (n = 8 per group): 1) Control (CON, HFHS diet) or 2) Ketone ester (KE, HFHS diet + BD-AcAc2, 25% by kcals). Results: Body weight increased by 56% in CON (27.8 ± 2.5 to 43.4 ± 3.7 g, p < 0.001) and by 13% in KE (28.0 ± 0.8 to 31.7 ± 3.1 g, p = 0.001). Non-alcoholic fatty liver disease activity scores (NAS) for hepatic steatosis, inflammation, and ballooning were lower in the KE group compared to CON (p < 0.001 for all). Markers of hepatic inflammation [Tnfα (p = 0.036); Mcp1 (p < 0.001)], macrophage content [(Cd68 (p = 0.012)], and collagen deposition and hepatic stellate cell activation [(αSma (p = 0.004); Col1A1 (p < 0.001)] were significantly lower in the KE group compared to CON. Conclusion: These findings extend those of our previous work and show that BD-AcAc2 attenuates the accretion of adiposity and reduces markers of liver steatosis, inflammation, ballooning, and fibrosis in lean mice placed on a HFHS diet where carbohydrate energy was not removed to accommodate energy from addition of the diester.
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Affiliation(s)
- Kelsey A. Rushing
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mickey L. Bolyard
- Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Taylor Kelty
- Research Service, Harry S. Truman Memorial Veterans’ Hospital, Department of Nutrition and Exercise Physiology, Medicine—Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, United States
| | - Nicole Wieschhaus
- Research Service, Harry S. Truman Memorial Veterans’ Hospital, Department of Nutrition and Exercise Physiology, Medicine—Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, United States
| | - Gregory Pavela
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - R. Scott Rector
- Research Service, Harry S. Truman Memorial Veterans’ Hospital, Department of Nutrition and Exercise Physiology, Medicine—Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, United States
| | - Eric P. Plaisance
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
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Dominguez LJ, Veronese N, Di Bella G, Cusumano C, Parisi A, Tagliaferri F, Ciriminna S, Barbagallo M. Mediterranean diet in the management and prevention of obesity. Exp Gerontol 2023; 174:112121. [PMID: 36792040 DOI: 10.1016/j.exger.2023.112121] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023]
Abstract
The current pandemic of obesity represents a major global public health problem, mainly due to its association with chronic non-communicable disabling conditions and with increased mortality. Population aging increases the chances of non-communicable chronic diseases allowing a longer exposure to risk factors for these disabling conditions. Obesity is a major risk factor contributing to pathological aging. Numerous epidemiological studies have shown that the risk of death due to cardiovascular disease and cancer increases progressively as overweight and obesity rise. Nutrition research is now focused on the effects of combinations of foods in dietary patterns instead of those of single nutrients or foods. The dietary model with the largest body of evidence of health benefit is that traditionally followed by inhabitants of some Mediterranean countries. There is evidence confirming the inverse association of adhering to Mediterranean diet with overweight and obesity. Four meta-analyses of randomized controlled trials, including up to 16 trials, have shown a greater reduction of body weight and BMI with MedDiet compared to other diets, while a meta-analysis of 7 prospective cohort studies, found a reduced risk of becoming obese and gaining weight over time associated with a higher adherence to MedDiet. This narrative review examines studies reporting inverse associations of a higher adherence to the MedDiet with overweight/obesity and with age-associated chronic diseases related to obesity.
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Affiliation(s)
- Ligia J Dominguez
- Faculty of Medicine and Surgery, "Kore" University of Enna, Enna, Italy; Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Giovanna Di Bella
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Claudia Cusumano
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Angela Parisi
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Federica Tagliaferri
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Stefano Ciriminna
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
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Noakes TD, Prins PJ, Volek JS, D’Agostino DP, Koutnik AP. Low carbohydrate high fat ketogenic diets on the exercise crossover point and glucose homeostasis. Front Physiol 2023; 14:1150265. [PMID: 37057184 PMCID: PMC10086139 DOI: 10.3389/fphys.2023.1150265] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
In exercise science, the crossover effect denotes that fat oxidation is the primary fuel at rest and during low-intensity exercise with a shift towards an increased reliance on carbohydrate oxidation at moderate to high exercise intensities. This model makes four predictions: First, >50% of energy comes from carbohydrate oxidation at ≥60% of maximum oxygen consumption (VO2max), termed the crossover point. Second, each individual has a maximum fat oxidation capacity (FATMAX) at an exercise intensity lower than the crossover point. FATMAX values are typically 0.3-0.6 g/min. Third, fat oxidation is minimized during exercise ≥85%VO2max, making carbohydrates the predominant energetic substrate during high-intensity exercise, especially at >85%VO2max. Fourth, high-carbohydrate low-fat (HCLF) diets will produce superior exercise performances via maximizing pre-exercise storage of this predominant exercise substrate. In a series of recent publications evaluating the metabolic and performance effects of low-carbohydrate high-fat (LCHF/ketogenic) diet adaptations during exercise of different intensities, we provide findings that challenge this model and these four predictions. First, we show that adaptation to the LCHF diet shifts the crossover point to a higher %VO2max (>80%VO2max) than previously reported. Second, substantially higher FATMAX values (>1.5 g/min) can be measured in athletes adapted to the LCHF diet. Third, endurance athletes exercising at >85%VO2max, whilst performing 6 × 800 m running intervals, measured the highest rates of fat oxidation yet reported in humans. Peak fat oxidation rates measured at 86.4 ± 6.2%VO2max were 1.58 ± 0.33 g/min with 30% of subjects achieving >1.85 g/min. These studies challenge the prevailing doctrine that carbohydrates are the predominant oxidized fuel during high-intensity exercise. We recently found that 30% of middle-aged competitive athletes presented with pre-diabetic glycemic values while on an HCLF diet, which was reversed on LCHF. We speculate that these rapid changes between diet, insulin, glucose homeostasis, and fat oxidation might be linked by diet-induced changes in mitochondrial function and insulin action. Together, we demonstrate evidence that challenges the current crossover concept and demonstrate evidence that a LCHF diet may also reverse features of pre-diabetes and future metabolic disease risk, demonstrating the impact of dietary choice has extended beyond physical performance even in athletic populations.
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Affiliation(s)
- T. D. Noakes
- Department of Medical and Wellness Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - P. J. Prins
- Department of Exercise Science, Grove City College, Grove City, PA, United States
| | - J. S. Volek
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - D. P. D’Agostino
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, United States
- Human Healthspan, Resilience and Performance, Institute of Human and Machine Cognition, Pensacola, FL, United States
| | - A. P. Koutnik
- Human Healthspan, Resilience and Performance, Institute of Human and Machine Cognition, Pensacola, FL, United States
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Malhotra V, Sawal A. Metabolic Effects of Ketogenic Diets and Their Utilization in Obesity Management: A Systematic Review. Cureus 2023; 15:e36720. [PMID: 37123756 PMCID: PMC10130479 DOI: 10.7759/cureus.36720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/26/2023] [Indexed: 05/02/2023] Open
Abstract
A ketogenic diet (KD), more commonly called a "keto" diet, is a dietary regime that focuses on reducing carbohydrates and replacing them with healthy fats. It has proven to improve health and has resurfaced as a trendy weight loss method. Keto, in simple terms, works by mimicking starvation and forcing the body to utilize and deplete fat as its core energy source instead of its usual source of glucose (sugar). More technically, it gives ignition to a process called 'ketosis'. Ketosis is the process of generation of ketone bodies when the liver metabolizes fat. There are several versions of this diet, each of which addresses slightly variable issues as well as hones unique requirements. Individuals will require a unique combination of fat, carbohydrates, and protein depending on their genetic and physical makeup. The advantages and hazards of using the KD to manage obesity are examined in this review of the literature.
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Affiliation(s)
- Vani Malhotra
- Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Anupama Sawal
- Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Hengist A, Davies RG, Rogers PJ, Brunstrom JM, van Loon LJC, Walhin JP, Thompson D, Koumanov F, Betts JA, Gonzalez JT. Restricting sugar or carbohydrate intake does not impact physical activity level or energy intake over 24 h despite changes in substrate use: a randomised crossover study in healthy men and women. Eur J Nutr 2023; 62:921-940. [PMID: 36326863 PMCID: PMC9941259 DOI: 10.1007/s00394-022-03048-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To determine the effects of dietary sugar or carbohydrate restriction on physical activity energy expenditure, energy intake, and physiological outcomes across 24 h. METHODS In a randomized, open-label crossover design, twenty-five healthy men (n = 10) and women (n = 15) consumed three diets over a 24-h period: moderate carbohydrate and sugar content (MODSUG = 50% carbohydrate [20% sugars], 15% protein, 35% fat); low sugar content (LOWSUG = 50% carbohydrate [< 5% sugars], 15% protein, 35% fat); and low carbohydrate content (LOWCHO = 8% carbohydrate [< 5% sugars], 15% protein, 77% fat). Postprandial metabolic responses to a prescribed breakfast (20% EI) were monitored under laboratory conditions before an ad libitum test lunch, with subsequent diet and physical activity monitoring under free-living conditions until blood sample collection the following morning. RESULTS The MODSUG, LOWSUG and LOWCHO diets resulted in similar mean [95%CI] rates of both physical activity energy expenditure (771 [624, 919] vs. 677 [565, 789] vs. 802 [614, 991] kcal·d-1; p = 0.29] and energy intake (2071 [1794, 2347] vs. 2195 [1918, 2473] vs. 2194 [1890, 2498] kcal·d-1; P = 0.34), respectively. The LOWCHO condition elicited the lowest glycaemic and insulinaemic responses to breakfast (P < 0.01) but the highest 24-h increase in LDL-cholesterol concentrations (P < 0.001), with no differences between the MODSUG and LOWSUG treatments. Leptin concentrations decreased over 24-h of consuming LOWCHO relative to LOWSUG (p < 0.01). CONCLUSION When energy density is controlled for, restricting either sugar or total dietary carbohydrate does not modulate physical activity level or energy intake over a 24-h period (~ 19-h free-living) despite substantial metabolic changes. CLINICAL TRIALS REGISTRATION ID NCT03509610, https://clinicaltrials.gov/show/NCT03509610.
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Affiliation(s)
- Aaron Hengist
- Department for Health, University of Bath, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Russell G Davies
- Department for Health, University of Bath, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Peter J Rogers
- School of Psychological Sciences, University of Bristol, Bristol, UK
| | - Jeff M Brunstrom
- School of Psychological Sciences, University of Bristol, Bristol, UK
| | - Luc J C van Loon
- Department of Human Biology, Maastricht University, Maastricht, The Netherlands
| | - Jean-Philippe Walhin
- Department for Health, University of Bath, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Françoise Koumanov
- Department for Health, University of Bath, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - James A Betts
- Department for Health, University of Bath, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Javier T Gonzalez
- Department for Health, University of Bath, Bath, BA2 7AY, UK.
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK.
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Perler BK, Friedman ES, Wu GD. The Role of the Gut Microbiota in the Relationship Between Diet and Human Health. Annu Rev Physiol 2023; 85:449-468. [PMID: 36375468 DOI: 10.1146/annurev-physiol-031522-092054] [Citation(s) in RCA: 64] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The interplay between diet, the gut microbiome, and host health is complex. Diets associated with health have many similarities: high fiber, unsaturated fatty acids, and polyphenols while being low in saturated fats, sodium, and refined carbohydrates. Over the past several decades, dietary patterns have changed significantly in Westernized nations with the increased consumption of calorically dense ultraprocessed foods low in fiber and high in saturated fats, salt, and refined carbohydrates, leading to numerous negative health consequences including obesity, metabolic syndrome, and cardiovascular disease. The gut microbiota is an environmental factor that interacts with diet and may also have an impact on health outcomes, many of which involve metabolites produced by the microbiota from dietary components that can impact the host. This review focuses on our current understanding of the complex relationship between diet, the gut microbiota, and host health, with examples of how diet can support health, increase an individual's risk for disease, and be used as a therapy for specific diseases.
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Affiliation(s)
- Bryce K Perler
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
| | - Elliot S Friedman
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
| | - Gary D Wu
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
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Effect of Low-Carbohydrate Diet on Beta-Hydroxybutyrate Ketogenesis Metabolic Stimulation and Regulation of NLRP3 Ubiquitination in Obese Saudi Women. Nutrients 2023; 15:nu15040820. [PMID: 36839178 PMCID: PMC9958539 DOI: 10.3390/nu15040820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/25/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
The effects of a ketogenic diet (KD) on anthropometric indices, the lipid profile, and the benefits of the ketone body beta-hydroxybutyrate (BHB) as an inhibitor of the NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome in obese women were investigated in this study. From January to March 2021, 23 obese adult women (n = 23) with an average age of 35.30 years and BMI of 33.96 kg/m2 followed a KD. Instructions for the KD were given to eligible participants, with a typical plan and a menu for all the main meals, snacks, and drinks permitted over seven days. They were also free to change meals according to their preferences provided that they followed the plan. The participants attended six times throughout the intervention for measurements of their anthropometric indices, BHB levels, interleukin-1beta (1L-1β) levels, and completion of a questionnaire (pre-intervention, mid-intervention, and post-intervention). Following the KD caused significant weight loss, a reduction in waist circumference and BHB levels, as well as a reduction in BMI and appetite. Cholesterol, triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) increased slightly. However, low-density lipoprotein cholesterol (LDL-C) in serum increased significantly (p < 0.05), and 1L-1β decreased significantly (p < 0.0001). The results show that the KD effectively encouraged weight loss and NLRP3 inflammasome inhibition. Based on the questionnaire results, it was found that a variety of physical symptoms, including overall energy, physical activity, mood, sleep, focus, skin conditions, and menstruation, had significantly improved.
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Corbin KD, Carnero EA, Allerton TD, Tillner J, Bock CP, Luyet PP, Göbel B, Hall KD, Parsons SA, Ravussin E, Smith SR. Glucagon-like peptide-1/glucagon receptor agonism associates with reduced metabolic adaptation and higher fat oxidation: A randomized trial. Obesity (Silver Spring) 2023; 31:350-362. [PMID: 36695055 PMCID: PMC9881753 DOI: 10.1002/oby.23633] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/16/2022] [Accepted: 10/02/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE This study tested the hypothesis that treatment with the glucagon-like peptide-1/glucagon receptor agonist SAR425899 would lead to a smaller decrease in sleeping metabolic rate (SMR; kilocalories/day) than expected from the loss of lean and fat mass (metabolic adaptation). METHODS This Phase 1b, double-blind, randomized, placebo-controlled study was conducted at two centers in inpatient metabolic wards. Thirty-five healthy males and females with overweight and obesity (age = 36.5 ± 7.1 years) were randomized to a calorie-reduced diet (-1000 kcal/d) and escalating doses (0.06-0.2 mg/d) of SAR425899 (n = 17) or placebo (n = 18) for 19 days. SMR was measured by whole-room calorimetry. RESULTS Both groups lost weight (-3.68 ± 1.37 kg placebo; -4.83 ± 1.44 kg SAR425899). Those treated with SAR425899 lost more weight, fat mass, and fat free mass (p < 0.05) owing to a greater achieved energy deficit than planned. The SAR425899 group had a smaller reduction in body composition-adjusted SMR (p = 0.002) as compared with placebo, but not 24-hour energy expenditure. Fat oxidation and ketogenesis increased in both groups, with significantly greater increases with SAR425899 (p < 0.05). CONCLUSIONS SAR425899 led to reduced selective metabolic adaptation and increased lipid oxidation, which are believed to be beneficial for weight loss and weight-loss maintenance.
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Affiliation(s)
- Karen D Corbin
- AdventHealth Translational Research Institute, Orlando, Florida, USA
| | - Elvis A Carnero
- AdventHealth Translational Research Institute, Orlando, Florida, USA
| | | | | | | | | | | | - Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | | | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Steven R Smith
- AdventHealth Translational Research Institute, Orlando, Florida, USA
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Graybeal AJ, Kreutzer A, Moss K, Rack P, Augsburger G, Braun-Trocchio R, Willis JL, Shah M. Chronic and Postprandial Metabolic Responses to a Ketogenic Diet Compared to High-Carbohydrate and Habitual Diets in Trained Competitive Cyclists and Triathletes: A Randomized Crossover Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1110. [PMID: 36673864 PMCID: PMC9859046 DOI: 10.3390/ijerph20021110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Extreme carbohydrate deficits during a ketogenic diet (KD) may result in metabolic adaptations reflective of low energy availability; however, the manifestation of these adaptations outside of exercise have yet to be elucidated in cyclists and triathletes. The purpose of this study is to investigate the chronic and postprandial metabolic responses to a KD compared to a high-carbohydrate diet (HCD) and habitual diet (HD) in trained competitive cyclists and triathletes. For this randomized crossover trial, six trained competitive cyclist and triathletes (F: 4, M: 2) followed an ad libitum KD and HCD for 14 d each after their HD. Fasting energy expenditure (EE), respiratory exchange ratio (RER), and fat and carbohydrate oxidation (FatOx and CarbOx, respectively) were collected during their HD and after 14 d on each randomly assigned KD and HCD. Postprandial measurements were collected on day 14 of each diet following the ingestion of a corresponding test meal. There were no significant differences in fasting EE, RER, FatOx, or CarbOx among diet conditions (all p > 0.050). Although postprandial RER and CarbOx were consistently lower following the KD meal, there were no differences in peak postprandial RER (p = 0.452), RER incremental area under the curve (iAUC; p = 0.416) postprandial FatOx (p = 0.122), peak FatOx (p = 0.381), or FatOx iAUC (p = 0.164) between the KD and HD meals. An ad libitum KD does not significantly alter chronic EE or substrate utilization compared to a HCD or HD; postprandial FatOx appears similar between a KD and HD; this is potentially due to the high metabolic flexibility of cyclists and triathletes and the metabolic adaptations made to habitual high-fat Western diets in practice. Cyclists and triathletes should consider these metabolic similarities prior to a KD given the potential health and performance impairments from severe carbohydrate restriction.
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Affiliation(s)
- Austin J. Graybeal
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Andreas Kreutzer
- Department of Kinesiology, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX 76129, USA
- School of Health Promotion and Kinesiology, College of Health Sciences, Texas Woman’s University, Denton, TX 76209, USA
| | - Kamiah Moss
- Department of Kinesiology, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX 76129, USA
- Physical Medicine and Rehabilitation, Baylor Institute for Rehabilitation, Dallas, TX 75246, USA
| | - Petra Rack
- Department of Kinesiology, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX 76129, USA
| | - Garrett Augsburger
- Department of Kinesiology, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX 76129, USA
| | - Robyn Braun-Trocchio
- Department of Kinesiology, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX 76129, USA
| | - Jada L. Willis
- Department of Nutritional Sciences, College of Science & Engineering, Texas Christian University, Fort Worth, TX 76129, USA
| | - Meena Shah
- Department of Kinesiology, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX 76129, USA
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Drabińska N, Romaszko J, White P. The effect of isocaloric, energy-restrictive, KETOgenic diet on metabolism, inflammation, nutrition deficiencies and oxidative stress in women with overweight and obesity (KETO-MINOX): Study protocol. PLoS One 2023; 18:e0285283. [PMID: 37155645 PMCID: PMC10166534 DOI: 10.1371/journal.pone.0285283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023] Open
Abstract
Obesity is considered one of the biggest health problems of the 21st century, becoming a worldwide epidemic, leading to the development of many diseases and increasing the risk of premature death. The first step in reducing body weight is a calorie-restricted diet. To date, there are many different diet types available, including the ketogenic diet (KD) which is recently gaining a lot of attention. However, all the physiological consequences of KD in the human body are not fully understood. Therefore, this study aims to evaluate the effectiveness of an eight-week, isocaloric, energy-restricted, KD as a weight management solution in women with overweight and obesity compared to a standard, balanced diet with the same calorie content. The primary outcome is to evaluate the effects of a KD on body weight and composition. The secondary outcomes are to evaluate the effect of KD-related weight loss on inflammation, oxidative stress, nutritional status, profiles of metabolites in breath, which informs about the metabolic changes in the body, obesity and diabetes-associated parameters, including a lipid profile, status of adipokines and hormones. Notably, in this trial, the long-term effects and efficiency of the KD will be studied. In summary, the proposed study will fill the gap in knowledge about the effects of KD on inflammation, obesity-associated parameters, nutritional deficiencies, oxidative stress and metabolism in a single study. ClinicalTrail.gov registration number: NCT05652972.
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Affiliation(s)
- Natalia Drabińska
- Department of Chemistry and Biodynamics of Food, Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Olsztyn, Poland
| | - Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Paul White
- Department of Mathematics and Data Science, University of the West of England, Bristol, United Kingdom
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Bakaj I, Pocai A. Metabolism-based approaches for autosomal dominant polycystic kidney disease. Front Mol Biosci 2023; 10:1126055. [PMID: 36876046 PMCID: PMC9980902 DOI: 10.3389/fmolb.2023.1126055] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023] Open
Abstract
Autosomal Dominant Polycystic Kidney Disease (ADPKD) leads to end stage kidney disease (ESKD) through the development and expansion of multiple cysts throughout the kidney parenchyma. An increase in cyclic adenosine monophosphate (cAMP) plays an important role in generating and maintaining fluid-filled cysts because cAMP activates protein kinase A (PKA) and stimulates epithelial chloride secretion through the cystic fibrosis transmembrane conductance regulator (CFTR). A vasopressin V2 receptor antagonist, Tolvaptan, was recently approved for the treatment of ADPKD patients at high risk of progression. However additional treatments are urgently needed due to the poor tolerability, the unfavorable safety profile, and the high cost of Tolvaptan. In ADPKD kidneys, alterations of multiple metabolic pathways termed metabolic reprogramming has been consistently reported to support the growth of rapidly proliferating cystic cells. Published data suggest that upregulated mTOR and c-Myc repress oxidative metabolism while enhancing glycolytic flux and lactic acid production. mTOR and c-Myc are activated by PKA/MEK/ERK signaling so it is possible that cAMPK/PKA signaling will be upstream regulators of metabolic reprogramming. Novel therapeutics opportunities targeting metabolic reprogramming may avoid or minimize the side effects that are dose limiting in the clinic and improve on the efficacy observed in human ADPKD with Tolvaptan.
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Affiliation(s)
- Ivona Bakaj
- Cardiovascular and Metabolism, Janssen Research and Development, Spring House, PA, United States
| | - Alessandro Pocai
- Cardiovascular and Metabolism, Janssen Research and Development, Spring House, PA, United States
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Du Y, Oh C, No J. Effects of the ketogenic diet on components of the metabolic syndrome: A systematic review and meta-analysis. NUTR CLIN METAB 2023. [DOI: 10.1016/j.nupar.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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